Provider Demographics
NPI:1285896365
Name:SOUTH CAROLINA EM-I MEDICAL SERVICES
Entity type:Organization
Organization Name:SOUTH CAROLINA EM-I MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / PARTNERSHIP
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:BYRNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-712-2000
Mailing Address - Street 1:18167 US 19 N
Mailing Address - Street 2:SUITE 285
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-3528
Mailing Address - Country:US
Mailing Address - Phone:800-507-8874
Mailing Address - Fax:727-507-3618
Practice Address - Street 1:1530 N LIMESTONE ST
Practice Address - Street 2:
Practice Address - City:GAFFNEY
Practice Address - State:SC
Practice Address - Zip Code:29340-4742
Practice Address - Country:US
Practice Address - Phone:864-487-1544
Practice Address - Fax:864-487-1634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty