Organization
LATTA RESCUE SQUAD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBBIE MCDANIEL (PRESIDENT)
(843) 752-4402
Entity
Organization
Contact information
Practice address
107 WEST BAMBERGG STREET, LATTA, SC 29565
(843) 752-4402
Mailing address
107 WEST BAMBERGG STREET, LATTA, SC 29565
(843) 752-4402
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
093
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AB0201
—
SC
05
—
Q328760001
—
SC
Enumeration date
10/02/2006
Last updated
11/13/2014
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