Provider Demographics
NPI:1043589948
Name:ABC TRANSPORT
Entity Type:Organization
Organization Name:ABC TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SERVICE PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JENNINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-783-3549
Mailing Address - Street 1:PO BOX 742
Mailing Address - Street 2:
Mailing Address - City:HARDEEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29927-0742
Mailing Address - Country:US
Mailing Address - Phone:843-783-3549
Mailing Address - Fax:
Practice Address - Street 1:2460 PAYNESVILLE ROAD
Practice Address - Street 2:
Practice Address - City:HARDEEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29927-0742
Practice Address - Country:US
Practice Address - Phone:843-783-3549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPPLIED FOR343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)