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General NPI Number Information
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NPI Number | 1316207574
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Entity Type | Organization
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Legal Business Name | SHORELINE MEDICAL TRANSPORT
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Dates
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Enumeration Date | 05/22/2012
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Last Update Date | 05/22/2012
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Provider Practice Location Address
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Address Line | 452 BROWNS COVE RD SUITE B
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City | RIDGELAND
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State | SC
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Zip | 29936-8164
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Country | US
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Telephone | 843-645-9191
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Fax | 843-645-9198
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Provider Business Mailing Address
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Address Line | 452 BROWNS COVE RD SUITE B
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City | RIDGELAND
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State | SC
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Zip | 29936-8164
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Country | US
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Telephone | 843-645-9191
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Fax | 843-645-9198
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Authorized Official
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Title or Position | OWNER
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Name | MR. SCOT PARSICK
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Credential | RN
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Telephone | 843-645-9191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 293
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License Number State | SC
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