Provider Demographics
NPI:1720379571
Name:MEDONE MEDICAL TRANSPORT, LLC
Entity Type:Organization
Organization Name:MEDONE MEDICAL TRANSPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:THIGPEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-206-9265
Mailing Address - Street 1:PO BOX 6701
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-6701
Mailing Address - Country:US
Mailing Address - Phone:843-661-7990
Mailing Address - Fax:
Practice Address - Street 1:3211A BRYSON DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-6011
Practice Address - Country:US
Practice Address - Phone:843-661-7990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2883416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport