Provider Demographics
NPI:1982608709
Name:GREENWOOD COUNTY EMS
Entity Type:Organization
Organization Name:GREENWOOD COUNTY EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GREENWOOD COUNTY TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:M
Authorized Official - Last Name:SPATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-942-8528
Mailing Address - Street 1:528 MONUMENT ST
Mailing Address - Street 2:STE 108
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-2634
Mailing Address - Country:US
Mailing Address - Phone:864-942-8633
Mailing Address - Fax:
Practice Address - Street 1:528 MONUMENT ST
Practice Address - Street 2:STE 108
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-2634
Practice Address - Country:US
Practice Address - Phone:864-942-8633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-09
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC035341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC502156Medicaid