Healthcare Provider Details

I. General information

NPI: 1124013834
Provider Name (Legal Business Name): MOBILECARE HEALTH SERVICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2926B LEAPHART RD
WEST COLUMBIA SC
29169-3659
US

IV. Provider business mailing address

2926B LEAPHART RD
WEST COLUMBIA SC
29169-3659
US

V. Phone/Fax

Practice location:
  • Phone: 803-926-2273
  • Fax: 803-926-9490
Mailing address:
  • Phone: 803-926-2273
  • Fax: 803-926-9490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number163
License Number StateSC

VIII. Authorized Official

Name: FRANK T TRENERY
Title or Position: PRESIDENT
Credential:
Phone: 803-926-2273