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Organization
MEDIC OF SOUTH CAROLINA, LLC
Active
Organization
MEDIC OF SOUTH CAROLINA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES ALLEN TISDALE (PRESIDENT)
(843) 968-9118
Entity
Organization
Contact information
Practice address
604 E BROAD ST, DARLINGTON, SC 29532
(843) 968-9118
(843) 878-9836
Mailing address
PO BOX 1335, HARTSVILLE, SC 29551-1335
(843) 968-9118
(843) 878-9836
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
382
SC DHEC
SC
05
—
AB0372
—
SC
Enumeration date
10/22/2016
Last updated
08/16/2022
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