Provider Demographics
NPI:1013375633
Name:THE PETERKIN GROUP
Entity Type:Organization
Organization Name:THE PETERKIN GROUP
Other - Org Name:PEE DEE TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:NA
Authorized Official - Phone:843-454-1282
Mailing Address - Street 1:404 CHERAW ST STE A
Mailing Address - Street 2:
Mailing Address - City:BENNETTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29512-2869
Mailing Address - Country:US
Mailing Address - Phone:843-454-1282
Mailing Address - Fax:843-454-1283
Practice Address - Street 1:404 CHERAW ST STE A
Practice Address - Street 2:
Practice Address - City:BENNETTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29512-2869
Practice Address - Country:US
Practice Address - Phone:843-454-1282
Practice Address - Fax:843-454-1283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)