| Organization Name: | PENDARVIS ENTERPRISE LLC |
| NPI Number: | 1023281607 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID WILSON PENDARVIS (OWNER/OPERATOR) |
| Mailing Address: | 5877 Charleston Hwy Bowman |
| State: | SC US |
| Postal Code: | 290188774 |
| Phone Number: | 8038291231 |
| Fax Number: | 8038291250 |
| NPI Enumeration Date: | 04/04/2008 |
| NPI Last Update Date: | 04/04/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | 087 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |