Healthcare Provider Details

I. General information

NPI: 1942576244
Provider Name (Legal Business Name): MOBI CARE MEDICAL TRANSPORT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2012
Last Update Date: 08/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 OFFICE PARK CT SUITE 201
COLUMBIA SC
29223-5948
US

IV. Provider business mailing address

2 OFFICE PARK CT SUITE 201
COLUMBIA SC
29223-5948
US

V. Phone/Fax

Practice location:
  • Phone: 803-462-1381
  • Fax: 877-821-9504
Mailing address:
  • Phone: 803-462-1381
  • Fax: 877-821-9504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. JIM BURR
Title or Position: OWNER
Credential:
Phone: 803-462-1381