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General NPI Number Information
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NPI Number | 1114811031
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Entity Type | Organization
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Legal Business Name | EAST
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Dates
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Enumeration Date | 06/05/2025
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 272 SCOTTISH HIGHLAND RD
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City | CLOVER
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State | SC
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Zip | 29710-7112
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Country | US
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Telephone | 704-651-0785
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Fax |
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Provider Business Mailing Address
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Address Line | 272 SCOTTISH HIGHLAND RD
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City | CLOVER
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State | SC
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Zip | 29710-7112
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Country | US
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Telephone | 704-651-0785
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | MRS. ELVIRA A EAST
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Credential | RESPIRATORY THERAPIS
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Telephone | 704-651-0785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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