Provider Demographics
NPI:1598871576
Name:SURETRANS LLC
Entity Type:Organization
Organization Name:SURETRANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:NEAL
Authorized Official - Last Name:ADCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:EMTB
Authorized Official - Phone:864-228-0248
Mailing Address - Street 1:216 CHICKAMAUGUA LN
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-3326
Mailing Address - Country:US
Mailing Address - Phone:864-228-0248
Mailing Address - Fax:864-963-2346
Practice Address - Street 1:201 FOWLER RD
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-3804
Practice Address - Country:US
Practice Address - Phone:864-228-0248
Practice Address - Fax:864-963-2346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC175341600000X
SC7023343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ343650001Medicare PIN