Organization Active NPI

Marion Rescue Squad Inc

  • Ambulance
  • Marion, SC
National Provider Identifier
1689906463
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
074 Issued in SC
Legal business name
MARION RESCUE SQUAD INC
Practice address
107 E Bond St
Marion, SC 29571-3627
Phone
(843) 289-2622
NPI assigned
Feb 4, 2010
Last updated
Jan 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Authorized official

Name
Chandler Tisdale
Title
Operations/Data Manager
Phone
(843) 423-8602

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 074 SC Primary

Addresses

Primary practice location

107 E Bond St
Marion, SC 29571-3627

Mailing address

PO Box 84278
Lexington, SC 29073-0005
Phone (803) 957-7111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100608000485 SC Part B Supplier - Ambulance Service Supplier 5294865879 Practice locations: Marion, SC

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
42D2040384Marion Rescue Squad Inc107 East Bond Street, Marion, SC 29571Certificate of waiverApr 29, 2028

National Provider Directory

National Provider Directory

Locations

107 E Bond St
Marion, SC 29571
Phone (843) 289-2622

601 E Godbold St
Marion, SC 29571
Phone (843) 423-8602

NPI Registry JSON

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

{
    "created_epoch": "1265241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705622400000",
    "number": "1689906463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84278",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290730005",
            "telephone_number": "803-957-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E BOND ST",
            "city": "MARION",
            "state": "SC",
            "postal_code": "295713627",
            "telephone_number": "843-289-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARION RESCUE SQUAD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-04",
        "last_updated": "2024-01-19",
        "certification_date": "2023-12-21",
        "status": "A",
        "authorized_official_last_name": "TISDALE",
        "authorized_official_first_name": "CHANDLER",
        "authorized_official_title_or_position": "OPERATIONS/DATA MANAGER",
        "authorized_official_telephone_number": "843-423-8602"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "SC",
            "license": "074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.