Provider Demographics
NPI:1104820752
Name:COUNTY OF LANCASTER
Entity type:Organization
Organization Name:COUNTY OF LANCASTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CLAYTON
Authorized Official - Middle Name:L
Authorized Official - Last Name:CATOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-416-9901
Mailing Address - Street 1:P.O. BOX 1809
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:SC
Mailing Address - Zip Code:29721-1809
Mailing Address - Country:US
Mailing Address - Phone:803-283-4134
Mailing Address - Fax:803-283-2092
Practice Address - Street 1:2006 PAGELAND HIGHWAY
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720
Practice Address - Country:US
Practice Address - Phone:803-283-4134
Practice Address - Fax:803-283-2092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-10
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC040 SC3416L0300X
SC0403416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC500130Medicaid
SC500130Medicaid