# MEDIC OF SOUTH CAROLINA, LLC

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

## Provider details

- **NPI number:** 1700337987
- **Authorized official:** CHARLES ALLEN TISDALE (PRESIDENT)
- **Authorized official phone:** (843) 968-9118

## Contact information

- **Practice address:** 604 E BROAD ST, DARLINGTON, SC 29532
- **Practice address phone:** (843) 968-9118
- **Practice address fax:** (843) 878-9836
- **Mailing address:** PO BOX 1335, HARTSVILLE, SC 29551-1335
- **Mailing address phone:** (843) 968-9118
- **Mailing address fax:** (843) 878-9836

## Taxonomy

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

## Other

- **Enumeration date:** 10/22/2016
- **Last updated:** 08/16/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 382 | SC DHEC | SC |
| 05 | — | AB0372 | — | SC |