Organization Active NPI

Medshore Ambulance Service

Doing business as Gold Cross Ambulance Service

  • Ambulance
  • West Columbia, SC
National Provider Identifier
1174621452
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
183 Issued in SC
Legal business name
MEDSHORE AMBULANCE SERVICE
Doing business as
Gold Cross Ambulance Service
Practice address
3038 Leaphart Rd
West Columbia, SC 29169-3022
Phone
(803) 794-8107
NPI assigned
Sep 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Greg L Shore
Title
Ceo
Phone
(864) 264-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 183 SC Primary

Addresses

Primary practice location

3038 Leaphart Rd
West Columbia, SC 29169-3022

Mailing address

PO Box 2105
Anderson, SC 29622-2105
Phone (864) 260-4600

Other identifiers 1

IdentifierTypeStateIssuer
AB0226MedicaidSC

Other names 1

  • Gold Cross Ambulance Service Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gold Cross Ambulance Service2 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

3038 Leaphart Rd
West Columbia, SC 29169
Phone (803) 794-8107

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174621452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2105",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296222105",
            "telephone_number": "864-260-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3038 LEAPHART RD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693022",
            "telephone_number": "803-794-8107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSHORE AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHORE",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "864-264-4600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "SC",
            "license": "183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AB0226",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gold Cross Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.