Healthcare Provider Details

I. General information

NPI: 1598871576
Provider Name (Legal Business Name): SURETRANS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 FOWLER RD
SIMPSONVILLE SC
29681-3804
US

IV. Provider business mailing address

216 CHICKAMAUGUA LN
SIMPSONVILLE SC
29681-3326
US

V. Phone/Fax

Practice location:
  • Phone: 864-228-0248
  • Fax: 864-963-2346
Mailing address:
  • Phone: 864-228-0248
  • Fax: 864-963-2346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number175
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number7023
License Number StateSC

VIII. Authorized Official

Name: MR. JERRY NEAL ADCOCK
Title or Position: OWNER
Credential: E.M.T.B.
Phone: 864-228-0248