Provider Demographics
NPI:1225021504
Name:ORANGEBURG COUNTY EMS
Entity Type:Organization
Organization Name:ORANGEBURG COUNTY EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNTY ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-533-6101
Mailing Address - Street 1:1558 ELLIS AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29118-2514
Mailing Address - Country:US
Mailing Address - Phone:803-533-6101
Mailing Address - Fax:803-533-6101
Practice Address - Street 1:1558 ELLIS AVE
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-2514
Practice Address - Country:US
Practice Address - Phone:803-957-7111
Practice Address - Fax:803-957-7115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC147341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC502879Medicaid