Provider Demographics
NPI:1225138472
Name:LAURENS COUNTY EMS
Entity Type:Organization
Organization Name:LAURENS COUNTY EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF EMS
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ULDRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-984-1574
Mailing Address - Street 1:PO BOX 391
Mailing Address - Street 2:
Mailing Address - City:LAURENS
Mailing Address - State:SC
Mailing Address - Zip Code:29360-0391
Mailing Address - Country:US
Mailing Address - Phone:864-984-1574
Mailing Address - Fax:864-984-0576
Practice Address - Street 1:321 S HARPER ST
Practice Address - Street 2:
Practice Address - City:LAURENS
Practice Address - State:SC
Practice Address - Zip Code:29360-3422
Practice Address - Country:US
Practice Address - Phone:864-984-1574
Practice Address - Fax:864-984-0576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0863416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC502290Medicaid
SC406590451OtherRAILROAD MEDICARE