Lake Robinson Rescue Squad

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

136 Issued in SC

Legal business name

LAKE ROBINSON RESCUE SQUAD

Practice address

2364 W Old Camden Rd
Hartsville, SC 29550-9400

Phone

(843) 398-4443

Fax

(843) 398-4447

NPI assigned

Aug 16, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Betty W Tanner, NREMTP

Title

Director

Phone

(843) 398-4443

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972595056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 HARTSVILLE AIRPORT RD",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295508459",
            "telephone_number": "843-398-4443",
            "fax_number": "843-398-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2364 W OLD CAMDEN RD",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295509400",
            "telephone_number": "843-398-4443",
            "fax_number": "843-398-4447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE ROBINSON RESCUE SQUAD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TANNER",
        "authorized_official_first_name": "BETTY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "843-398-4443",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NREMTP"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "SC",
            "license": "136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AB0237",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Alice King, MS, LPES, LPC
• Omarion Dashawn Kirkland
• Amanda Farmer Kissiah
• KND Development 59, LLC
• Jean Kohn, MD
• Wanda Gale Langley-Hassler
• Amy Law, PHARMD
• Jacqueline Phipps Lawhon, LDO
• Brenda Lawson
• Jeffrey Adam Lear

• Land Ambulance in Hartsville, SC
• Providers in Hartsville, SC by specialty
• Land Ambulance in South Carolina

• 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.