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General NPI Number Information
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NPI Number | 1659991990
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Entity Type | Organization
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Legal Business Name | 4OURBOYS LLC
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Dates
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Enumeration Date | 04/16/2020
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Last Update Date | 04/16/2020
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Provider Practice Location Address
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Address Line | 1643 HIGHWAY 544
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City | CONWAY
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State | SC
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Zip | 29526-8452
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Country | US
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Telephone | 843-347-2928
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Fax |
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Provider Business Mailing Address
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Address Line | 3828 BECKFORD ST
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City | FLORENCE
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State | SC
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Zip | 29501-8157
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SCARLETT LUTZ
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Credential |
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Telephone | 843-307-5838
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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 |
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License Number State |
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