Organization
WACCAMAW MEDICAL TRANSPORT, INC.
Active
Other names
Lifestar
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS MAYNARD SEARS JR. JD (GENERAL COUNSEL)
(843) 662-8887
Entity
Organization
Contact information
Practice address
3926 WESLEY ST, SUITE 202, MYRTLE BEACH, SC 29579-7332
(843) 903-5290
Mailing address
1935 2ND LOOP RD, FLORENCE, SC 29501-6173
(843) 662-8887
(843) 662-9920
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
5101266
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4206858
—
NC
Enumeration date
01/10/2008
Last updated
02/07/2008
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