MEDICARE: MISS SHARGARTICER S BRYANT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance

General Provider Information

NPI Number	:	1669659207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS SHARGARTICER S BRYANT

Provider Business Mailing Address
First Line	:	324 MOORE ST
Second Line	:
City	:	LAKE CITY
State	:	SC
Zip	:	29560-2325
Country	:	US
Telephone Number	:	843-245-0718
Fax Number	:

Provider Business Practice Location Address
First Line	:	324 MOORE ST
Second Line	:
City	:	LAKE CITY
State	:	SC
Zip	:	29560-2325
Country	:	US
Telephone Number	:	843-245-0718
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2008
Last Update Date	:	01/25/2008

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Directions to “ MISS SHARGARTICER S BRYANT ” Practice Location

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