Provider Demographics
NPI:1164869673
Name:COUNTY OF GEORGETOWN
Entity Type:Organization
Organization Name:COUNTY OF GEORGETOWN
Other - Org Name:MIDWAY FIRE RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:EGGIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-545-3603
Mailing Address - Street 1:67 SAINT PAULS PL
Mailing Address - Street 2:
Mailing Address - City:PAWLEYS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29585-4330
Mailing Address - Country:US
Mailing Address - Phone:843-545-3603
Mailing Address - Fax:843-545-3242
Practice Address - Street 1:67 SAINT PAULS PL
Practice Address - Street 2:
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585-4330
Practice Address - Country:US
Practice Address - Phone:843-545-3603
Practice Address - Fax:843-545-3242
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF GEORGETOWN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-24
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC135341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance