Organization Active NPI

Allendale County Rescue Squad Inc

  • Land Ambulance
  • Allendale, SC
National Provider Identifier
1083693832
Registry record updated Nov 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
ALLENDALE COUNTY RESCUE SQUAD INC
Practice address
606 Hickory St
Allendale, SC 29810
Phone
(803) 584-4900
Fax
(803) 584-0400
NPI assigned
Jan 11, 2006
Last updated
Nov 30, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2012

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

Authorized official

Name
Mr. John Marshall Lawson III, PARAMEDIC DIRECTOR
Title
Director Captain
Phone
(803) 584-4900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

606 Hickory St
Allendale, SC 29810

Mailing address

PO Box 1245
Walterboro, SC 29488
Phone (843) 549-3444

Other identifiers 1

IdentifierTypeStateIssuer
502076MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050927000124 SC Part B Supplier - Ambulance Service Supplier 8123052362 Practice locations: Allendale, SC

National Provider Directory

National Provider Directory
Tax ID family
Allendale Rescue Squad2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

660 Hickory St N
Allendale, SC 29810
Phone (803) 584-4900

911 Main St N
Ste C
Allendale, SC 29810
Phone (803) 584-4900

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354233600000",
    "number": "1083693832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1245",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "29488",
            "telephone_number": "843-549-3444",
            "fax_number": "843-549-3474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 HICKORY ST",
            "city": "ALLENDALE",
            "state": "SC",
            "postal_code": "29810",
            "telephone_number": "803-584-4900",
            "fax_number": "803-584-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLENDALE COUNTY RESCUE SQUAD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-11",
        "last_updated": "2012-11-30",
        "status": "A",
        "authorized_official_last_name": "LAWSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MARSHALL",
        "authorized_official_title_or_position": "DIRECTOR CAPTAIN",
        "authorized_official_telephone_number": "803-584-4900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PARAMEDIC DIRECTOR"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "502076",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allendale, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.