Crystal River Medical Transportation LLC

Primary specialty

AmbulanceTaxonomy code 341600000X

License

613 Issued in SC

Legal business name

CRYSTAL RIVER MEDICAL TRANSPORTATION LLC

Practice address

104 Dean CT
Lexington, SC 29073-2907

Phone

(803) 849-9962

NPI assigned

Dec 7, 2017

Organization subpart

No

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

Authorized official

Name

Elton Mishoe

Title

Director

Phone

(803) 849-9962

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1512604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512604800000",
    "number": "1669987087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1468 BOILING SPRINGS RD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290737342",
            "telephone_number": "803-849-9962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 DEAN CT",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290732907",
            "telephone_number": "803-849-9962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL RIVER MEDICAL TRANSPORTATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-07",
        "last_updated": "2017-12-07",
        "status": "A",
        "authorized_official_last_name": "MISHOE",
        "authorized_official_first_name": "ELTON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "803-849-9962"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "SC",
            "license": "613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulance in Lexington, SC
• Providers in Lexington, SC by specialty
• Ambulance in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2017; 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.