Provider Demographics
NPI:1568063709
Name:ACT MEDICAL TRANSPORT SERVICES LLC
Entity Type:Organization
Organization Name:ACT MEDICAL TRANSPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LYDELL
Authorized Official - Middle Name:V
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-351-9274
Mailing Address - Street 1:P.O BOX 1448
Mailing Address - Street 2:
Mailing Address - City:TRAVELERS REST
Mailing Address - State:SC
Mailing Address - Zip Code:29690
Mailing Address - Country:US
Mailing Address - Phone:864-613-5900
Mailing Address - Fax:864-689-1202
Practice Address - Street 1:316 POPLAR ST EXT
Practice Address - Street 2:
Practice Address - City:TRAVELERS REST
Practice Address - State:SC
Practice Address - Zip Code:29690
Practice Address - Country:US
Practice Address - Phone:864-613-5900
Practice Address - Fax:864-689-1202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle