PORT CITY AMBULANCE SERVICE LLC NPI 1194200063

NPI Information

NPI: 1194200063
Provider Name: PORT CITY AMBULANCE SERVICE LLC
Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

CLIA Number: 42D2167307

Address:
543 LONG POINT RD STE 104
MOUNT PLEASANT, SC
ZIP 29464
Phone: (843) 800-1112
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PORT CITY AMBULANCE SERVICE LLC is a land transport ambulance in Mount Pleasant, SC. PORT CITY AMBULANCE SERVICE LLC NPI is 1194200063. The provider is registered as an organization entity type.

The provider's business location address is:

543 LONG POINT RD STE 104
MOUNT PLEASANT, SC
ZIP 29464-360
Phone: (843) 800-1112
Fax: (843) 972-3040

The provider's authorized official is Brian E Peagler .
The authorized official title is Managing Member and has the following contact phone number (843) 270-2391.

The CLIA number assigned to this NPI record is 42D2167307 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/26/2018 and was last updated on 4/19/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	3416L0300X	Ambulance	Land Transport			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	632	OTHER	SOUTH CAROLINA	SC DHEC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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