Provider Demographics
NPI:1649268798
Name:PICKENS COUNTY EMS
Entity type:Organization
Organization Name:PICKENS COUNTY EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ELROD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-423-2683
Mailing Address - Street 1:PO BOX 1245
Mailing Address - Street 2:
Mailing Address - City:WALTERBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29488-0013
Mailing Address - Country:US
Mailing Address - Phone:843-549-3444
Mailing Address - Fax:843-549-3474
Practice Address - Street 1:1509 WALHALLA HWY
Practice Address - Street 2:
Practice Address - City:PICKENS
Practice Address - State:SC
Practice Address - Zip Code:29671-9678
Practice Address - Country:US
Practice Address - Phone:864-898-5726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-12
Last Update Date:2023-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC501692Medicaid