Provider Demographics
NPI:1982120176
Name:CITY OF BEAUFORT
Entity Type:Organization
Organization Name:CITY OF BEAUFORT
Other - Org Name:BEAUFORT/PORT ROYAL FIRE DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:CAPTAIN TRAINING/EDCUATION
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:843-525-7035
Mailing Address - Street 1:135 RIBAUT RD
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-4449
Mailing Address - Country:US
Mailing Address - Phone:843-525-7055
Mailing Address - Fax:843-525-7031
Practice Address - Street 1:135 RIBAUT RD
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-4449
Practice Address - Country:US
Practice Address - Phone:843-525-7055
Practice Address - Fax:843-525-7031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC385146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC385OtherSC DHEC LICENSE