Organization Active NPI

Volunteer Rescue Squad of Myrtle Beach Inc

Doing business as Myrtle Beach Rescue

  • Ambulance
  • Myrtle Beach, SC
National Provider Identifier
1396794442
Registry record updated May 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
158 Issued in SC
Legal business name
VOLUNTEER RESCUE SQUAD OF MYRTLE BEACH INC
Doing business as
Myrtle Beach Rescue
Practice address
3116 Shetland LN BLDG Unit2425
Myrtle Beach, SC 29577
Phone
(843) 457-0600
NPI assigned
May 8, 2006
Last updated
May 18, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2018

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

Authorized official

Name
Victoria Elizabeth Moshoures, MD
Title
MD/Director
Phone
(843) 267-3837

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 158 SC Primary

Addresses

Primary practice location

3116 Shetland LN BLDG Unit2425
Myrtle Beach, SC 29577

Mailing address

5005 Sunset Blvd
Lexington, SC 29072-9154
Phone (803) 957-7111

Other names 1

  • Myrtle Beach Rescue Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2091339Myrtle Beach Rescue Squad3116 Shetland Lane Suite 24 and 25, Myrtle Beach, SC 29577Certificate of waiverFeb 10, 2027

National Provider Directory

National Provider Directory

Locations

1004 Carver St
Myrtle Beach, SC 29577
Phone (843) 626-7352

3116 Shetland Ln
Unit 24
Myrtle Beach, SC 29577
Phone (843) 626-7352

3116 Shetland Ln
Unit 2425
Myrtle Beach, SC 29577
Phone (843) 457-0600

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526601600000",
    "number": "1396794442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 SUNSET BLVD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290729154",
            "telephone_number": "803-957-7111",
            "fax_number": "803-957-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3116 SHETLAND LN BLDG UNIT2425",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29577",
            "telephone_number": "843-457-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VOLUNTEER RESCUE SQUAD OF MYRTLE BEACH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2018-05-18",
        "status": "A",
        "authorized_official_last_name": "MOSHOURES",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "MD/DIRECTOR",
        "authorized_official_telephone_number": "843-267-3837",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "SC",
            "license": "158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Myrtle Beach Rescue",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Myrtle Beach Rescue",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.