Healthcare Provider Details

I. General information

NPI: 1710419692
Provider Name (Legal Business Name): TRANSPRO MEDICAL TRANSPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2017
Last Update Date: 03/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 CENTER DR
MYRTLE BEACH SC
29572-5613
US

IV. Provider business mailing address

1625 MOONLIGHT DR
MYRTLE BEACH SC
29575-5737
US

V. Phone/Fax

Practice location:
  • Phone: 843-691-9123
  • Fax:
Mailing address:
  • Phone: 843-691-9123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: NATALIE ANN CARUTHERS
Title or Position: COO
Credential:
Phone: 843-691-9123