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Organization
MAVERICK MEDICAL TRANSPORT LLC
Active
Organization
MAVERICK MEDICAL TRANSPORT LLC
Active
Other names
Maverick Medical Transport
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH CARL STAPLES JR. DO (COM)
(843) 902-7582
Entity
Organization
Contact information
Practice address
6820 LESLIE LEWIS RD, MULLINS, SC 29574-5897
(843) 902-7582
Mailing address
4690 J H MARTIN RD, GALIVANTS FERRY, SC 29544-6568
(843) 902-7582
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
NULL
Other
Enumeration date
07/23/2024
Last updated
07/23/2024
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