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General NPI Number Information
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NPI Number | 1679013742
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Entity Type | Organization
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Legal Business Name | CRUSIN SAFE LLC
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Dates
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Enumeration Date | 03/08/2017
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Last Update Date | 03/08/2017
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Provider Practice Location Address
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Address Line | 234 APACHE DR
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City | SUMMERVILLE
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State | SC
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Zip | 29483-9232
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Country | US
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Telephone | 843-300-8433
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Fax |
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Provider Business Mailing Address
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Address Line | 234 APACHE DR
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City | SUMMERVILLE
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State | SC
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Zip | 29483-9232
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Country | US
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Telephone | 843-300-8433
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NATAJA BOWMAN
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Credential |
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Telephone | 843-300-8433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 100045844
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License Number State | SC
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