Organization
CRYSTAL RIVER MEDICAL TRANSPORTATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELTON MISHOE (DIRECTOR)
(803) 849-9962
Entity
Organization
Contact information
Practice address
104 DEAN CT, LEXINGTON, SC 29073-2907
(803) 849-9962
Mailing address
1468 BOILING SPRINGS RD, LEXINGTON, SC 29073-7342
(803) 849-9962
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
613
SC
Other
Enumeration date
12/07/2017
Last updated
12/07/2017
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