Provider Demographics
NPI:1710316468
Name:FAST TRAC TRANSPORTATION INC
Entity Type:Organization
Organization Name:FAST TRAC TRANSPORTATION INC
Other - Org Name:FAST TRAC AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TREVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:RUTLEDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-419-8486
Mailing Address - Street 1:10 SOUTHWARK CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-5213
Mailing Address - Country:US
Mailing Address - Phone:803-419-8486
Mailing Address - Fax:803-419-6361
Practice Address - Street 1:7340 PARKLANE RD
Practice Address - Street 2:204 G
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-7644
Practice Address - Country:US
Practice Address - Phone:803-419-8486
Practice Address - Fax:803-419-6361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport