Provider Demographics
NPI:1770107591
Name:YELLOW CAB COMPANY OF CHARLESTON
Entity type:Organization
Organization Name:YELLOW CAB COMPANY OF CHARLESTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:CROSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-722-2222
Mailing Address - Street 1:2019 CHERRY HILL LN
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-9309
Mailing Address - Country:US
Mailing Address - Phone:843-722-2222
Mailing Address - Fax:
Practice Address - Street 1:2019 CHERRY HILL LN
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-9309
Practice Address - Country:US
Practice Address - Phone:843-722-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC7000283581OtherSC PROCUREMENT SERVICES