Williston Rescue Squad

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

009 Issued in SC

Legal business name

WILLISTON RESCUE SQUAD

Practice address

80 Rescue Squad Blvd
Williston, SC 29853-2304

Phone

(803) 266-7019

Fax

(803) 266-7701

NPI assigned

May 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Gene A. Williams

Title

Director

Phone

(803) 266-7019

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207699200000",
    "number": "1023062544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 151",
            "city": "WILLISTON",
            "state": "SC",
            "postal_code": "298530151",
            "telephone_number": "803-266-7019",
            "fax_number": "803-266-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 RESCUE SQUAD BLVD",
            "city": "WILLISTON",
            "state": "SC",
            "postal_code": "298532304",
            "telephone_number": "803-266-7019",
            "fax_number": "803-266-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLISTON RESCUE SQUAD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2008-04-09",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "GENE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "803-266-7019",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "SC",
            "license": "009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "502030",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyh Williston Opco LLC
• Walgreen Co
• Richard Jeremy Wallace, PA-C
• Jonathan West, PHARMD
• Williston Healthcare and Rehab, LLC
• Janice Dukes Wright, MSP, CCC-SLP
• Brittany Wyndham
• Amy E Zorn, RPH

• All providers in Williston, SC
• Land Ambulance in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.