Healthcare Provider Details

I. General information

NPI: 1164082350
Provider Name (Legal Business Name): LOW COUNTY NEMT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2019
Last Update Date: 06/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

291 HWY 90 EAST UNIT 291-B
LITTLE RIVER SC
29566-7613
US

IV. Provider business mailing address

291 HWY 90 EAST UNIT 291-B
LITTLE RIVER SC
29566-7613
US

V. Phone/Fax

Practice location:
  • Phone: 843-663-0348
  • Fax: 843-663-0348
Mailing address:
  • Phone: 843-663-0348
  • Fax: 843-663-0348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MS. SAMANTHA JADE BERKLEY
Title or Position: OWNER
Credential:
Phone: 843-663-0348