1992798250 NPI number — MCCORMICK 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 1992798250 NPI number — MCCORMICK COUNTY EMS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MCCORMICK 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:
1992798250
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/12/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
608 S MINE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MC CORMICK
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29835-8000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-852-2811
Provider Business Mailing Address Fax Number:
864-852-3435

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
608 S MINE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MC CORMICK
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29835-8000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-852-2811
Provider Business Practice Location Address Fax Number:
864-852-3435
Provider Enumeration Date:
08/23/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KATSAPIS
Authorized Official First Name:
MORGAN
Authorized Official Middle Name:
LANE
Authorized Official Title or Position:
ADMIN ASSISTANT
Authorized Official Telephone Number:
864-852-2811

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  210 , 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: AB0095 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".