Provider Demographics
NPI:1710991054
Name:PACOLET MILLS RESCUE SQUAD, INC
Entity Type:Organization
Organization Name:PACOLET MILLS RESCUE SQUAD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:NREMTP,LPN
Authorized Official - Phone:864-674-6262
Mailing Address - Street 1:P.O. BOX 39
Mailing Address - Street 2:
Mailing Address - City:PACOLET
Mailing Address - State:SC
Mailing Address - Zip Code:29372-0039
Mailing Address - Country:US
Mailing Address - Phone:864-474-2539
Mailing Address - Fax:864-674-1795
Practice Address - Street 1:980 SUNNY ACRES ROAD
Practice Address - Street 2:
Practice Address - City:PACOLET
Practice Address - State:SC
Practice Address - Zip Code:29372-0980
Practice Address - Country:US
Practice Address - Phone:864-474-2539
Practice Address - Fax:864-674-1795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11900341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAB0103Medicaid
SCQ29011001Medicare ID - Type Unspecified