Provider Demographics
NPI:1093011256
Name:EAST PALMETTO AMBULANCE SERVICE LLC
Entity Type:Organization
Organization Name:EAST PALMETTO AMBULANCE SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-473-8000
Mailing Address - Street 1:1830 GREELEYVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:MANNING
Mailing Address - State:SC
Mailing Address - Zip Code:29102-4418
Mailing Address - Country:US
Mailing Address - Phone:803-460-8800
Mailing Address - Fax:843-549-3474
Practice Address - Street 1:3694 GREELEYVILLE HWY
Practice Address - Street 2:
Practice Address - City:MANNING
Practice Address - State:SC
Practice Address - Zip Code:29102-6197
Practice Address - Country:US
Practice Address - Phone:803-473-8000
Practice Address - Fax:803-473-8001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-07
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2803416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport