Provider Demographics
NPI:1114088234
Name:FAMILY MEDICAL TRANSPORT LLC
Entity Type:Organization
Organization Name:FAMILY MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:BARUCH
Authorized Official - Last Name:ABRAMS
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:843-276-5579
Mailing Address - Street 1:P O BOX 30488
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29417-0488
Mailing Address - Country:US
Mailing Address - Phone:843-225-0460
Mailing Address - Fax:843-769-4555
Practice Address - Street 1:1855 BELGRADE AVENUE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-5713
Practice Address - Country:US
Practice Address - Phone:843-769-4280
Practice Address - Fax:843-225-4280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC165341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAB0208Medicaid