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General NPI Number Information
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NPI Number | 1922765775
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Entity Type | Organization
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Legal Business Name | MCGILL MEDICAL TRANSPORT
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Dates
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Enumeration Date | 11/29/2021
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Last Update Date | 11/29/2021
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Provider Practice Location Address
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Address Line | 335 N. TOM GASQUE AVE.
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City | MARION
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State | SC
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Zip | 29571
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Country | US
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Telephone | 843-289-5078
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Fax | 843-289-5094
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Provider Business Mailing Address
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Address Line | P.O. BOX 1467
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City | MARION
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State | SC
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Zip | 29571
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Country | US
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Telephone | 848-289-5078
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MR. JACKIE FITZGERALD MCGILL SR.
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Credential |
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Telephone | 843-245-7974
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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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