Provider Demographics
NPI:1578577557
Name:LOW COUNTRY MEDICAL TRANSPORT INC
Entity Type:Organization
Organization Name:LOW COUNTRY MEDICAL TRANSPORT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HATTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ASKEW
Authorized Official - Suffix:
Authorized Official - Credentials:DIRECTOR
Authorized Official - Phone:803-943-3939
Mailing Address - Street 1:PO BOX 912
Mailing Address - Street 2:
Mailing Address - City:VARNVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29944-0912
Mailing Address - Country:US
Mailing Address - Phone:803-943-3939
Mailing Address - Fax:803-943-0612
Practice Address - Street 1:61 HICKORY HILL ROAD
Practice Address - Street 2:
Practice Address - City:VARNVILLE
Practice Address - State:SC
Practice Address - Zip Code:29944
Practice Address - Country:US
Practice Address - Phone:803-943-3939
Practice Address - Fax:803-943-3783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1302343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAB0235Medicaid
SCAB0235Medicaid