Theodore O Wilson Foundation

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

THEODORE O WILSON FOUNDATION

Practice address

107 E Mill St
Kingstree, SC 29556-3427

Phone

(843) 687-3843

Fax

(843) 407-7297

NPI assigned

Jul 11, 2012

Last updated

Jul 11, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tanya W Mullins

Title

Chairperson

Phone

(843) 687-6843

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341964800000",
    "number": "1669737060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 662",
            "city": "KINGSTREE",
            "state": "SC",
            "postal_code": "295560662",
            "telephone_number": "843-687-6843",
            "fax_number": "843-407-7297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E MILL ST",
            "city": "KINGSTREE",
            "state": "SC",
            "postal_code": "295563427",
            "telephone_number": "843-687-3843",
            "fax_number": "843-407-7297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEODORE O WILSON FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-11",
        "last_updated": "2012-07-11",
        "status": "A",
        "authorized_official_last_name": "MULLINS",
        "authorized_official_first_name": "TANYA",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CHAIRPERSON",
        "authorized_official_telephone_number": "843-687-6843"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2012; 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.