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General NPI Number Information
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NPI Number | 1417954587
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Entity Type | Organization
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Legal Business Name | CITY OF GOOSE CREEK
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Dates
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Enumeration Date | 07/05/2005
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 519 N GOOSE CREEK BLVD
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City | GOOSE CREEK
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State | SC
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Zip | 29445-2962
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Country | US
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Telephone | 843-797-6220
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Fax | 843-863-5208
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Provider Business Mailing Address
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Address Line | PO BOX 1768
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City | GOOSE CREEK
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State | SC
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Zip | 29445-1768
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Country | US
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Telephone | 843-797-6220
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Fax | 843-572-0155
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Authorized Official
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Title or Position | FINANCE DIRECTOR
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Name | MR. TYLER D HOWANYK
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Credential |
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Telephone | 843-797-6220
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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 | 18201
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License Number State | SC
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