| Organization Name: | SOCIETY HILL RESCUE SQUAD |
| NPI Number: | 1669837936 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARLES ALLEN TISDALE (PARAMEDIC / ASST CAPTAIN) |
| Mailing Address: | 280 S Main St Society Hill |
| State: | SC US |
| Postal Code: | 29593 |
| Phone Number: | 8432504436 |
| Fax Number: | |
| NPI Enumeration Date: | 12/30/2015 |
| NPI Last Update Date: | 12/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | 066 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |