1649268798 NPI number — PICKENS COUNTY EMS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649268798 NPI number — PICKENS COUNTY EMS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PICKENS COUNTY EMS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649268798
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/11/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1245
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WALTERBORO
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29488-0013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-549-3444
Provider Business Mailing Address Fax Number:
843-549-3474

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1509 WALHALLA HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PICKENS
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29671-9678
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-898-5726
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/12/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TESKE
Authorized Official First Name:
MEREDITH
Authorized Official Middle Name:
Authorized Official Title or Position:
EMS DIRECTOR
Authorized Official Telephone Number:
864-898-5335

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 501692 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".