Provider Demographics
NPI:1891056933
Name:SAINT MATTHEWS AMBULANCE SERVICE OF THE MIDLANDS, LLC
Entity Type:Organization
Organization Name:SAINT MATTHEWS AMBULANCE SERVICE OF THE MIDLANDS, LLC
Other - Org Name:FOR LIFE MEDICAL TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASST DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-445-2600
Mailing Address - Street 1:454 CROMER RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-9488
Mailing Address - Country:US
Mailing Address - Phone:803-445-2600
Mailing Address - Fax:803-445-2300
Practice Address - Street 1:454 CROMER RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29073-9488
Practice Address - Country:US
Practice Address - Phone:803-445-2600
Practice Address - Fax:803-445-2300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-05
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC334341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance