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General NPI Number Information
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NPI Number | 1801154349
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Entity Type | Organization
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Legal Business Name | JASPER COUNTH EMS
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Dates
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Enumeration Date | 05/02/2012
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Last Update Date | 05/02/2012
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Provider Practice Location Address
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Address Line | 1509 GRAYS HWY
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City | RIDGELAND
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State | SC
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Zip | 29936-5441
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Country | US
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Telephone | 843-726-7816
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Fax | 843-726-7966
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Provider Business Mailing Address
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Address Line | 1509 GRAYS HWY P. O. BOX 1509
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City | RIDGELAND
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State | SC
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Zip | 29936-5441
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Country | US
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Telephone | 843-726-7816
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Fax | 843-726-7966
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. GEORGIA DELOACH
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Credential |
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Telephone | 843-726-7816
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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 | 27203
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License Number State | SC
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