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General NPI Number Information
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NPI Number | 1104818152
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Entity Type | Organization
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Legal Business Name | CAPITAL CITY AMBULANCE INC
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Dates
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Enumeration Date | 08/16/2005
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Last Update Date | 10/15/2007
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Provider Practice Location Address
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Address Line | 106 NEW DELAUGHTER DR
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City | NORTH AUGUSTA
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State | SC
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Zip | 29860-8471
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Country | US
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Telephone | 803-442-7555
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Fax | 803-279-1275
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Provider Business Mailing Address
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Address Line | PO BOX 6365
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City | NORTH AUGUSTA
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State | SC
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Zip | 29861-6365
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Country | US
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Telephone | 803-442-7555
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Fax | 803-279-1275
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Authorized Official
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Title or Position | CFO
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Name | MS. NANCY L HICKSON
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Credential |
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Telephone | 803-442-7555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 215 541190608903
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License Number State | SC
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