Provider Demographics
NPI:1952984866
Name:ADVANTAGE CARE OF PEE DEE LLC
Entity Type:Organization
Organization Name:ADVANTAGE CARE OF PEE DEE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-687-8015
Mailing Address - Street 1:1001 W EVANS ST STE 102
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-3388
Mailing Address - Country:US
Mailing Address - Phone:843-536-7196
Mailing Address - Fax:843-472-5212
Practice Address - Street 1:1001 W EVANS ST STE 102
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-3388
Practice Address - Country:US
Practice Address - Phone:843-536-7196
Practice Address - Fax:843-472-5212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-29
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport