# LAKESIDE MEDICAL RESPONSE TRI COUNTY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598176158
- **Authorized official:** MR. JAMES MARION MCDUFFIE II (PRESIDENT)
- **Authorized official phone:** (843) 260-0922

## Contact information

- **Practice address:** 1801D W EVANS ST STE 110, FLORENCE, SC 29501-3333
- **Practice address phone:** (843) 571-0702
- **Practice address fax:** (843) 571-0306
- **Mailing address:** 1937 W PALMETTO ST, SUITE 163, FLORENCE, SC 29501-3916
- **Mailing address phone:** (843) 571-0702
- **Mailing address fax:** (843) 571-0306

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | — | NULL | — |
| 3416L0300X | Land Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 05/16/2014
- **Last updated:** 03/14/2024