Healthcare Provider Details

I. General information

NPI: 1932077302
Provider Name (Legal Business Name): ACTIVE SC TWO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2025
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 S LINE STREET EXT
GREER SC
29651-4027
US

IV. Provider business mailing address

6 INTERPLEX DR STE 401
TREVOSE PA
19053-6942
US

V. Phone/Fax

Practice location:
  • Phone: 215-642-6600
  • Fax: 215-827-5950
Mailing address:
  • Phone: 215-642-6600
  • Fax: 215-827-5950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE VANSCHAICK
Title or Position: REGULATORY & CONTRACT ANALYST
Credential:
Phone: 215-642-6600