Provider Demographics
NPI:1730441858
Name:SOUTHERN URGENT TRANSPORT LLC
Entity type:Organization
Organization Name:SOUTHERN URGENT TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO
Authorized Official - Prefix:
Authorized Official - First Name:FARHOD
Authorized Official - Middle Name:
Authorized Official - Last Name:MURADOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-349-0086
Mailing Address - Street 1:216 LABONTE ST.
Mailing Address - Street 2:SUITE D
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526
Mailing Address - Country:US
Mailing Address - Phone:843-349-0086
Mailing Address - Fax:843-349-0093
Practice Address - Street 1:216 LABONTE ST.
Practice Address - Street 2:SUITE D
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526
Practice Address - Country:US
Practice Address - Phone:843-349-0086
Practice Address - Fax:843-349-0093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3173416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport