Provider Demographics
NPI:1720007818
Name:MEDXPRESS TRANSPORT, LLC
Entity Type:Organization
Organization Name:MEDXPRESS TRANSPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:F
Authorized Official - Last Name:URQUHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-413-0911
Mailing Address - Street 1:525 S DARGAN ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-2549
Mailing Address - Country:US
Mailing Address - Phone:843-413-0911
Mailing Address - Fax:843-669-8911
Practice Address - Street 1:525 S DARGAN ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2549
Practice Address - Country:US
Practice Address - Phone:843-431-3091
Practice Address - Fax:843-669-8911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC042341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAB0215Medicaid
SCQ331160001Medicare ID - Type Unspecified