| Organization Name: | SPRINGLAKE MEDICAL TRANSPORT, LLC |
| NPI Number: | 1609280890 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEBORAH KAYE BROWN (OWNER/MEMBER) |
| Mailing Address: | 2904 S Highway 41 Mullins |
| State: | SC US |
| Postal Code: | 295745534 |
| Phone Number: | 8434646700 |
| Fax Number: | 8434646400 |
| NPI Enumeration Date: | 06/16/2014 |
| NPI Last Update Date: | 06/16/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |