| Organization Name: | LAKESIDE MEDICAL RESPONSE TRI COUNTY, LLC |
| NPI Number: | 1598176158 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES MARION MCDUFFIE (PRESIDENT) |
| Mailing Address: | 1954 Ashley River Rd Suite D Charleston |
| State: | SC US |
| Postal Code: | 294074904 |
| Phone Number: | 8435710702 |
| Fax Number: | 8435710306 |
| NPI Enumeration Date: | 05/16/2014 |
| NPI Last Update Date: | 05/16/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 341600000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An emergency vehicle used for transporting patients to a health care facility after injury or illness. Types of ambulances used in the United States include ground (surface) ambulance, rotor-wing (helicopter), and fixed-wing aircraft (airplane). |