MEDICARE: PRIME PATH EMS LLC

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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1942151741
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIME PATH EMS LLC

Provider Business Mailing Address
First Line	:	1285 SIX MILE RD
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29466-6802
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1285 SIX MILE RD
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29466-6802
Country	:	US
Telephone Number	:	843-475-7207
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	BRANDON MAZYCK
Credential	:
Telephone Number	:	843-475-7207

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	02/06/2026

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Directions to “PRIME PATH EMS LLC ” Practice Location

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