MEDSTAR AMBULANCE SERVICE, LLC (NPI# 1639155112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639155112 |
| Entity Type | Organization |
| Organization Name | MEDSTAR AMBULANCE SERVICE, LLC |
| Practice Address |
1322 Broughton Blvd Florence SC 29501 |
| Practice Telephone | 8436697827 |
| Practice Fax Number | 8436693279 |
| Mailing Telephone | 8436697827 |
| Mailing Fax Number | 8436693279 |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2011-04-15 |
| Authorized Official Name | TOMMY B JONES (CEO/OWNER) |
| Authorized Official Telephone | 8436697827 |
| Authorized Official Credential | PARAMEDIC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 343900000X | Non-emergency Medical Transport (VAN) | 068 | SC | Transportation Services |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | AB0203 | 05 |
| Street Address |
1322 BROUGHTON BLVD |
| City | FLORENCE |
| State | SC |
| Zip Code | 29501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821460502 | Medstar Medical Transport | Ambulance | 1322 Broughton Blvd, Florence, SC 29501-6979 | 2015-10-21 |
| 1710166970 | Pee Dee Ambulance, LLC | Ambulance | 1322 Broughton Blvd, Florence, SC 29501-6979 | 2007-10-24 |
| 1740269141 | Carolina Medcare | Ambulance | 1322 Broughton Blvd, Florence, SC 29501-6979 | 2006-01-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700350444 | Angel Edwards Brown | Nurse Practitioner | Mcleod Health, 555 East Cheves Street, Florence, SC 29501 | 2019-01-16 |
| 1497229124 | Fred L. Evans IIi | Physical Therapy Assistant | 2439 Willwood Dr., Florence, SC 29501 | 2019-01-16 |
| 1841715596 | Faith Hope Love Homecare | Home Health | 604 S. Coit Street, Florence, SC 29501 | 2017-08-03 |
| 1083156350 | Karen Artis-bacote | Nurse Practitioner | 3835 Susan Dr, Florence, SC 29501 | 2016-11-17 |
| 1992251581 | Higher Ground Christian Counseling Service, LLC | Counselor | 1801 D West Evans Street, Florence, SC 29501 | 2016-09-01 |
| 1952752818 | Jack Carter Shackelford | Chiropractor | 311 West Palmetto Street, Florence, SC 29501 | 2016-06-22 |
| 1750743506 | Profection Therapy LLC | Clinic/Center | 315d North Beltline Dr., Florence, SC 29501 | 2016-03-22 |
| 1386002467 | Bergelt Optometric LLC | Optometrist | 2672 David Mcleod Blvd, Florence, SC 29501 | 2016-02-04 |
| 1437531993 | Sherika Tarshall Stuckey | Nurse Practitioner | 720 Coventry Lane, Apt C, Florence, SC 29501 | 2015-06-22 |
| 1245610062 | Christopher Tyree | Podiatrist | 709 W Evans St, Florence, SC 29501 | 2015-06-06 |
| Find all providers in zip 29501 | ||||
| Taxonomy Code | 343900000X |
| Grouping | Transportation Services |
| Classification | Non-emergency Medical Transport (VAN) |
| A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962530 | Nathan Bryant | Non-emergency Medical Transport (VAN) | 519b W Darlington St, Florence, SC 29501-2413 | 2020-11-05 |
| 1891305389 | Leaf Transporation Company | Non-emergency Medical Transport (VAN) | 2724 Boardwalk, Florence, SC 29505-6651 | 2020-08-09 |
| 1043835663 | Candace Stewart | Non-emergency Medical Transport (VAN) | 903 S Santiago Dr Unit F, Florence, SC 29501-6048 | 2020-06-09 |
| 1922631977 | Urban Transportation,llc | Non-emergency Medical Transport (VAN) | 116 S Aiken Dr Apt 4a, Florence, SC 29501-4100 | 2020-02-18 |
| 1407495963 | Derrick Campbell Dba Derrions Transportation | Non-emergency Medical Transport (VAN) | 237 Laurel Ln Lot 2, Florence, SC 29506-7106 | 2020-01-02 |
| 1558826974 | Greater Cincinnati Transportation | Non-emergency Medical Transport (VAN) | 75 Cavalier Blvd Ste 320, Florence, KY 41042-3964 | 2019-02-11 |
| 1316440829 | Joy Grimes Walker | Non-emergency Medical Transport (VAN) | 2975 Bridle Cir, Florence, SC 29505-7026 | 2018-03-10 |
| 1659664316 | Charles Spears II | Non-emergency Medical Transport (VAN) | 623 Garden Hills Dr, Florence, SC 29505-3940 | 2011-05-26 |
| 1487965257 | Wheelchair Transportation and Taxi Cab Services, LLC | Non-emergency Medical Transport (VAN) | 104 Victoria Ct, Florence, AL 35630-6622 | 2010-06-28 |
| 1518295740 | Eric Justin Cannon | Non-emergency Medical Transport (VAN) | 632 King Ave, Florence, SC 29501-4331 | 2009-11-30 |
| Find all providers in FLORENCE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.