Organization
CUSTOM CARE CARRIAGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SIMEON GLAUBACH (PRESIDENT)
(843) 608-0788
Entity
Organization
Contact information
Practice address
1692 W SANDCROFT DR, CHARLESTON, SC 29407-3067
(843) 608-0788
Mailing address
1692 W SANDCROFT DR, CHARLESTON, SC 29407-3067
(843) 608-0788
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
12/12/2020
Last updated
12/12/2020
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