Organization
RIVERSIDE AMBULANCE SERVICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUG MCDANIEL (MANAGING PARTNER)
(803) 641-6434
Entity
Organization
Contact information
Practice address
1 BUSINESS CT, SUITE A, AIKEN, SC 29801-4096
(803) 641-6434
(803) 641-6436
Mailing address
1 BUSINESS CT, SUITE A, AIKEN, SC 29801-4096
(803) 641-6434
(803) 641-6436
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
256
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q353540001
MEDICARE PTAN
SC
Enumeration date
10/21/2009
Last updated
03/15/2010
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