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General NPI Number Information
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NPI Number | 1427067115
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Entity Type | Organization
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Legal Business Name | WELLFORD RESCUE 21
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 242 N CRAFT ST
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City | WELLFORD
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State | SC
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Zip | 29385-9629
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Country | US
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Telephone | 864-439-7377
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1245
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City | WALTERBORO
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State | SC
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Zip | 29488-0013
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Country | US
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Telephone | 843-549-3444
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Fax | 843-549-3474
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Authorized Official
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Title or Position | DIRECTOR
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Name | TONIA GIBBS
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Credential |
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Telephone | 864-439-7377
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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 | 110
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License Number State | SC
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