Provider Demographics
NPI:1649512492
Name:PAMPLICO RESCUE AND AMBULANCE SERVICE
Entity type:Organization
Organization Name:PAMPLICO RESCUE AND AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:H
Authorized Official - Last Name:WALKUP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-493-0457
Mailing Address - Street 1:PO BOX 532
Mailing Address - Street 2:
Mailing Address - City:PAMPLICO
Mailing Address - State:SC
Mailing Address - Zip Code:29583-0532
Mailing Address - Country:US
Mailing Address - Phone:843-493-0457
Mailing Address - Fax:
Practice Address - Street 1:217 E. THIRD AVE
Practice Address - Street 2:
Practice Address - City:PAMPLICO
Practice Address - State:SC
Practice Address - Zip Code:29583-0532
Practice Address - Country:US
Practice Address - Phone:843-493-0457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-20
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC027341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance