Healthcare Provider Details

I. General information

NPI: 1992049373
Provider Name (Legal Business Name): NON MEDICAL TRANSPORT CARE,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2012
Last Update Date: 11/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

383 KNIGHTS AVE
WALTERBORO SC
29488-6506
US

IV. Provider business mailing address

383 KNIGHTS AVE
WALTERBORO SC
29488-6506
US

V. Phone/Fax

Practice location:
  • Phone: 843-599-4592
  • Fax:
Mailing address:
  • Phone: 843-599-4592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License NumberZP-120457
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberZP-120457
License Number StateSC

VIII. Authorized Official

Name: CINDY ELAINE PETER
Title or Position: OWNER
Credential:
Phone: 843-599-4592