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General NPI Number Information
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NPI Number | 1104901727
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Entity Type | Organization
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Legal Business Name | MARLBORO COUNTY RESCUE SQUAD INC
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 03/14/2016
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Provider Practice Location Address
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Address Line | 207 BALL PARK ST
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City | BENNETTSVILLE
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State | SC
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Zip | 29512-3158
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Country | US
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Telephone | 843-479-2644
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 80
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City | BENNETTSVILLE
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State | SC
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Zip | 29512-0080
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Country | US
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Telephone | 843-479-2644
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JENNIFER DRIGGERS
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Credential |
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Telephone | 843-479-2644
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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 | 00140
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License Number State | SC
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