Provider Demographics
NPI:1093756850
Name:AMS OF WEST COLUMBIA INC
Entity Type:Organization
Organization Name:AMS OF WEST COLUMBIA INC
Other - Org Name:AMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:COCHRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-739-8101
Mailing Address - Street 1:3935 SUNSET BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-2403
Mailing Address - Country:US
Mailing Address - Phone:803-739-8101
Mailing Address - Fax:803-939-3031
Practice Address - Street 1:3935 SUNSET BLVD STE C
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-2403
Practice Address - Country:US
Practice Address - Phone:803-739-8101
Practice Address - Fax:803-939-3031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSCDHEC CERT. #116341600000X, 343900000X
SCSCDHEC CERT. # 1163416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAB0251Medicaid
SCQ341340001Medicare PIN