MEDICARE: PENDLETON AREA RESCUE SQUAD

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	3416L0300X	Land Ambulance	006	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710963244
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PENDLETON AREA RESCUE SQUAD

Provider Business Mailing Address
First Line	:	PO BOX 185
Second Line	:
City	:	PENDLETON
State	:	SC
Zip	:	29670-0185
Country	:	US
Telephone Number	:	864-646-7431
Fax Number	:	864-646-7097

Provider Business Practice Location Address
First Line	:	1 DEPOT STREET
Second Line	:
City	:	PENDLETON
State	:	SC
Zip	:	29670
Country	:	US
Telephone Number	:	864-646-7431
Fax Number	:	864-646-7097

Authorized Official
Title or Position	:	CHAIRMAN OF THE BOARD OF DIRECTORS
Name	:	MR. JAMES LAWRY ALLEN
Credential	:
Telephone Number	:	864-646-7431

Provider Enumeration Date	:	12/16/2005
Last Update Date	:	08/22/2020

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Directions to “PENDLETON AREA RESCUE SQUAD ” Practice Location

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