# LAKESIDE MEDICAL RESPONSE

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

## Provider details

- **NPI number:** 1811085657
- **Authorized official:** MRS. SHAMEEKA MCDUFFIE (OWNER)
- **Authorized official phone:** (843) 629-7133

## Contact information

- **Practice address:** 1801D W EVANS ST STE 110, FLORENCE, SC 29501-3333
- **Practice address phone:** (843) 629-7133
- **Practice address fax:** (843) 629-7233
- **Mailing address:** 1801D W EVANS ST STE 110, FLORENCE, SC 29501-3333
- **Mailing address phone:** (843) 629-7133
- **Mailing address fax:** (843) 629-7233

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 234 | SC | Yes |

## Other

- **Enumeration date:** 10/10/2006
- **Last updated:** 04/20/2021