Provider Demographics
NPI:1114811031
Name:EAST
Entity type:Organization
Organization Name:EAST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELVIRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:EAST
Authorized Official - Suffix:
Authorized Official - Credentials:RESPIRATORY THERAPIS
Authorized Official - Phone:704-651-0785
Mailing Address - Street 1:272 SCOTTISH HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:CLOVER
Mailing Address - State:SC
Mailing Address - Zip Code:29710-7112
Mailing Address - Country:US
Mailing Address - Phone:704-651-0785
Mailing Address - Fax:
Practice Address - Street 1:272 SCOTTISH HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:CLOVER
Practice Address - State:SC
Practice Address - Zip Code:29710-7112
Practice Address - Country:US
Practice Address - Phone:704-651-0785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)