Healthcare Provider Details

I. General information

NPI: 1083422455
Provider Name (Legal Business Name): M.A.P. II TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2024
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 SURREY CT STE 200
COLUMBIA SC
29212-3172
US

IV. Provider business mailing address

13 SURREY CT STE 200
COLUMBIA SC
29212-3172
US

V. Phone/Fax

Practice location:
  • Phone: 803-451-0328
  • Fax:
Mailing address:
  • Phone: 803-451-0328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: DARYL CLARK
Title or Position: OWNER/OPERATOR
Credential:
Phone: 229-672-4281