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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. VANESSA J LYBRAND (ADMIN/V.P.)
(803) 754-1418
Entity
Organization

Contact information

Practice address
4507 N MAIN ST, COLUMBIA, SD 29203-5793
(803) 754-1418
(803) 691-8934
Mailing address
4507 N MAIN ST, COLUMBIA, SC 29203-5793
(803) 754-1418
(803) 691-8934

Taxonomy

Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
2008360A
SC

Other

Enumeration date
07/27/2009
Last updated
08/03/2009
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