Provider Demographics
NPI:1275789810
Name:VITAL CARE AMBULANCE SERVICE, LLC.
Entity Type:Organization
Organization Name:VITAL CARE AMBULANCE SERVICE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-473-8200
Mailing Address - Street 1:PO BOX 1308
Mailing Address - Street 2:
Mailing Address - City:WALTERBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29488-0032
Mailing Address - Country:US
Mailing Address - Phone:843-549-3444
Mailing Address - Fax:843-549-3474
Practice Address - Street 1:3662 GREELEYVILLE HWY
Practice Address - Street 2:
Practice Address - City:MANNING
Practice Address - State:SC
Practice Address - Zip Code:29102
Practice Address - Country:US
Practice Address - Phone:803-473-8200
Practice Address - Fax:803-473-8201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC247341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance