Healthcare Provider Details

I. General information

NPI: 1972742369
Provider Name (Legal Business Name): T & E COMMUNITY RESOURCE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2009
Last Update Date: 09/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1943 BOYD RD
SCRANTON SC
29591-5835
US

IV. Provider business mailing address

1943 BOYD RD
SCRANTON SC
29591-5835
US

V. Phone/Fax

Practice location:
  • Phone: 843-325-5590
  • Fax: 843-407-7297
Mailing address:
  • Phone: 843-325-5590
  • Fax: 843-407-7297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number81738
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number7978
License Number StateSC

VIII. Authorized Official

Name: DON E WILSON
Title or Position: DIRECTOR
Credential: NREMT-P
Phone: 843-325-5590