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Eric Justin Cannon
Private Vehicle in Florence, South Carolina
NPI 1518295740

Eric Justin Cannon is a Private Vehicle based in Florence, SC. Eric Justin Cannon practices in Florence, SC. The NPI Number for Eric Justin Cannon is 1518295740 and holds a License No. 343900000X (South Carolina).

The current practice location address for Eric Justin Cannon is 632 King Ave, Florence, SC and can be reached out via phone at 843-453-2891 and via fax at 843-662-1995.

Location: 632 King Ave, Florence, SC, 29502-7246
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1518295740
Provider Name
Eric Justin Cannon
Credential
Provider Entity Type
Individual
Gender
Male
Address
632 King Ave, Florence, SC, 29502-7246
Phone Number
843-453-2891
Fax Number
843-662-1995
Provider Enumeration Date
11/30/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
PCS/ORS 8156 01 SC ORS- OFFICE OF REGULATORY STAFF
institution
Provider Business Practice Location Address Details
Address
632 King Ave
City
Florence
State
South Carolina
Zip
29501-4331
Phone Number
843-453-2891
Fax Number
843-662-1995
person
Provider Business Mailing Address Details
Address
632 King Ave
City
Florence
State
South Carolina
Zip
29501-4331
Phone Number
843-453-2891
Fax Number
843-662-1995
person
Provider's Taxonomy Details 1
Type
Transportation Services
Classification
Non-emergency Medical Transport (VAN)
Speciality
-
Taxonomy
343900000X
License No.
347C00000X (South Carolina)
Definition
A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations.
person
Provider's Taxonomy Details 2
Type
Transportation Services
Classification
Private Vehicle
Speciality
-
Taxonomy
347C00000X
License No.
343900000X (South Carolina)
Definition
An individual paid to provide non-emergency transportation using their privately owned/leased vehicle.
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