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Organization
WACCAMAW MEDICAL TRANSPORT, INC.
Active
Organization
WACCAMAW MEDICAL TRANSPORT, INC.
Active
Other names
Lifestar
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS MAYNARD SEARS JR. JD (GENERAL COUNSEL)
(843) 662-8887
Entity
Organization
Contact information
Practice address
3926 WESLEY ST, SUITE 202, MYRTLE BEACH, SC 29579-7332
(843) 903-5290
Mailing address
1935 2ND LOOP RD, FLORENCE, SC 29501-6173
(843) 662-8887
(843) 662-9920
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
5101266
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4206858
—
NC
Enumeration date
01/10/2008
Last updated
02/07/2008
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