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General NPI Number Information
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NPI Number | 1548851066
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Entity Type | Organization
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Legal Business Name | JTC VENTURES LLC DBAUPSTATE MOBILITY
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Dates
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Enumeration Date | 01/27/2021
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Last Update Date | 02/01/2021
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Provider Practice Location Address
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Address Line | 508 SE MAIN ST
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City | SIMPSONVILLE
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State | SC
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Zip | 29681-3216
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Country | US
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Telephone | 864-757-1601
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Fax | 864-757-8141
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Provider Business Mailing Address
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Address Line | PO BOX 81208
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City | SIMPSONVILLE
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State | SC
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Zip | 29680-0021
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Country | US
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Telephone | 864-757-1601
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Fax | 864-757-8141
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Authorized Official
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Title or Position | OWNER/MEMBER
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Name | JOHN CULP
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Credential |
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Telephone | 864-757-1601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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