Provider Demographics
NPI:1902985484
Name:CLEMSON UNIVERSITY
Entity Type:Organization
Organization Name:CLEMSON UNIVERSITY
Other - Org Name:CLEMSON UNIVERSITY FIRE AND EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:N
Authorized Official - Last Name:CRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-650-1461
Mailing Address - Street 1:PO BOX 602704
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2704
Mailing Address - Country:US
Mailing Address - Phone:855-626-9660
Mailing Address - Fax:833-953-0588
Practice Address - Street 1:1521 PERIMETER RD
Practice Address - Street 2:FIRE STATION
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29634-4010
Practice Address - Country:US
Practice Address - Phone:864-656-2242
Practice Address - Fax:864-656-3555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1533416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00778268OtherRAILROAD MEDICARE
SCAB0186Medicaid