Provider Demographics
NPI:1700839370
Name:HORRY COUNTY GOVERNMENT
Entity Type:Organization
Organization Name:HORRY COUNTY GOVERNMENT
Other - Org Name:HORRY COUNTY FIRE RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIVISION CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:GERRALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-915-7057
Mailing Address - Street 1:PO BOX 603246
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3246
Mailing Address - Country:US
Mailing Address - Phone:844-292-2771
Mailing Address - Fax:914-741-1325
Practice Address - Street 1:2560 MAIN ST
Practice Address - Street 2:STE. 1
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-3756
Practice Address - Country:US
Practice Address - Phone:844-292-2771
Practice Address - Fax:914-741-1325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0370003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC502085Medicaid
SC502085Medicaid