Provider Demographics
NPI:1922468909
Name:PRINCE GEORGE TRANSPORT
Entity Type:Organization
Organization Name:PRINCE GEORGE TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GRAHAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:I
Authorized Official - Credentials:EMTB
Authorized Official - Phone:803-231-9420
Mailing Address - Street 1:200 LOUTHIAN WAY
Mailing Address - Street 2:
Mailing Address - City:BLYTHEWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29016-7902
Mailing Address - Country:US
Mailing Address - Phone:803-213-9420
Mailing Address - Fax:
Practice Address - Street 1:200 LOUTHIAN WAY
Practice Address - Street 2:
Practice Address - City:BLYTHEWOOD
Practice Address - State:SC
Practice Address - Zip Code:29016
Practice Address - Country:US
Practice Address - Phone:803-231-9420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-03
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCE30448513416L0300X
SCSC0244613416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport