Provider Demographics
NPI:1467857011
Name:EXTREME MEDICAL TRANSPORT OF THE CAROLINAS LLC
Entity Type:Organization
Organization Name:EXTREME MEDICAL TRANSPORT OF THE CAROLINAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-774-4117
Mailing Address - Street 1:2538 HIGHWAY 301 S
Mailing Address - Street 2:SUITE -C
Mailing Address - City:DILLON
Mailing Address - State:SC
Mailing Address - Zip Code:29536-8217
Mailing Address - Country:US
Mailing Address - Phone:843-774-4117
Mailing Address - Fax:843-774-4194
Practice Address - Street 1:2538 HIGHWAY 301 S
Practice Address - Street 2:SUITE -C
Practice Address - City:DILLON
Practice Address - State:SC
Practice Address - Zip Code:29536-8217
Practice Address - Country:US
Practice Address - Phone:843-774-4117
Practice Address - Fax:843-774-4194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3493416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport