Provider Demographics
NPI:1992239834
Name:WALLACE FIRE RESCUE
Entity type:Organization
Organization Name:WALLACE FIRE RESCUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-910-0806
Mailing Address - Street 1:PO BOX 245
Mailing Address - Street 2:
Mailing Address - City:WALLACE
Mailing Address - State:SC
Mailing Address - Zip Code:29596-0245
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4013 HIGHWAY 177
Practice Address - Street 2:
Practice Address - City:WALLACE
Practice Address - State:SC
Practice Address - Zip Code:29596-8811
Practice Address - Country:US
Practice Address - Phone:843-910-0806
Practice Address - Fax:843-253-5119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-18
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable