# MED ATLANTIC MEDICAL TRANSPORT LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Med Atlantic LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912709650
- **Authorized official:** MR. JUSTIN RASHAWN MACK (OWNER)
- **Authorized official phone:** (843) 615-2122

## Contact information

- **Practice address:** 621 PEARL ST, DARLINGTON, SC 29532-3841
- **Practice address phone:** (843) 615-2122
- **Practice address fax:** (843) 944-0511
- **Mailing address:** 621 PEARL ST, DARLINGTON, SC 29532-3841
- **Mailing address phone:** (843) 615-2122
- **Mailing address fax:** (843) 944-0511

## Taxonomy

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

## Other

- **Enumeration date:** 03/25/2025
- **Last updated:** 03/25/2025