Provider Demographics
NPI:1285690875
Name:BAMBERG RESCUE SQUAD, INC
Entity type:Organization
Organization Name:BAMBERG RESCUE SQUAD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAMMETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-245-2024
Mailing Address - Street 1:PO BOX 443
Mailing Address - Street 2:
Mailing Address - City:BAMBERG
Mailing Address - State:SC
Mailing Address - Zip Code:29003-0443
Mailing Address - Country:US
Mailing Address - Phone:803-245-2024
Mailing Address - Fax:803-245-1729
Practice Address - Street 1:2378 MAIN HWY
Practice Address - Street 2:
Practice Address - City:BAMBERG
Practice Address - State:SC
Practice Address - Zip Code:29003-2700
Practice Address - Country:US
Practice Address - Phone:803-245-2024
Practice Address - Fax:803-245-1729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0083416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC501941Medicaid
SC501941Medicaid