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General NPI Number Information
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NPI Number | 1427154780
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Entity Type | Organization
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Legal Business Name | COUNTY OF COLLETON
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 07/29/2014
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Provider Practice Location Address
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Address Line | 113 MABEL T WILLIS BLVD
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City | WALTERBORO
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State | SC
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Zip | 29488-4522
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Country | US
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Telephone | 843-539-1960
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Fax | 843-539-1963
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Provider Business Mailing Address
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Address Line | PO BOX 41205
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City | CHARLESTON
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State | SC
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Zip | 29423-8068
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Country | US
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Telephone | 843-539-1960
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Fax | 843-539-1963
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SHEILA COCHRAN
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Credential |
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Telephone | 843-539-1960
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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 | 115
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 115
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License Number State | SC
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