Healthcare Provider Details

I. General information

NPI: 1497612618
Provider Name (Legal Business Name): CAROLINA MEDRIDE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1183 OSCAR DR
HAMER SC
29547-7281
US

IV. Provider business mailing address

1183 OSCAR DR
HAMER SC
29547-7281
US

V. Phone/Fax

Practice location:
  • Phone: 843-617-3425
  • Fax:
Mailing address:
  • Phone: 843-617-3425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State

VIII. Authorized Official

Name: ANTAMARIE DAWKINS
Title or Position: CEO
Credential:
Phone: 843-617-3425