Provider Demographics
NPI:1932135431
Name:REGIONAL AMBULANCE SERVICE, INC
Entity Type:Organization
Organization Name:REGIONAL AMBULANCE SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DARRIN
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:MOYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-392-7107
Mailing Address - Street 1:1089 AUGUSTA RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WARRENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29851-2903
Mailing Address - Country:US
Mailing Address - Phone:803-392-7107
Mailing Address - Fax:803-392-7137
Practice Address - Street 1:1089 AUGUSTA RD
Practice Address - Street 2:SUITE 300
Practice Address - City:WARRENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29851-2903
Practice Address - Country:US
Practice Address - Phone:803-392-7107
Practice Address - Fax:803-392-7137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2183416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAB0211Medicaid
SCAB0211Medicaid