Provider Demographics
NPI:1598034795
Name:WE PROVIDE MEDICAL TRANSPORT,LLC
Entity Type:Organization
Organization Name:WE PROVIDE MEDICAL TRANSPORT,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RONVER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MISHOE
Authorized Official - Suffix:SR
Authorized Official - Credentials:OWNER
Authorized Official - Phone:843-488-4550
Mailing Address - Street 1:2521 S CARTERSVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:TIMMONSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29161-8042
Mailing Address - Country:US
Mailing Address - Phone:803-369-1112
Mailing Address - Fax:
Practice Address - Street 1:1607 OAK ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-3085
Practice Address - Country:US
Practice Address - Phone:843-488-4550
Practice Address - Fax:843-488-4550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)