Individual
MACEO P PAIGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
519 DANWOODY RD, LATTA, SC 29565-5349
(843) 624-5091
Mailing address
519 DANWOODY RD, LATTA, SC 29565-5349
(843) 624-5091
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
831257126
—
SC
Enumeration date
01/31/2023
Last updated
01/31/2023
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