MEDICARE: CARL G. MCCRAW JR & CO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	HC0028	NC
2	251E00000X	Home Health Agency	HC0029	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285709808
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARL G. MCCRAW JR & CO

Provider Business Mailing Address
First Line	:	3707 LATROBE DR
Second Line	:	SUITE 460
City	:	CHARLOTTE
State	:	NC
Zip	:	28211-1164
Country	:	US
Telephone Number	:	704-366-7054
Fax Number	:	704-365-8181

Provider Business Practice Location Address
First Line	:	3707 LATROBE DR
Second Line	:	SUITE 460
City	:	CHARLOTTE
State	:	NC
Zip	:	28211-1164
Country	:	US
Telephone Number	:	704-366-7054
Fax Number	:	704-365-8181

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. CARL G. MCCRAW JR.
Credential	:
Telephone Number	:	704-366-7054

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	08/22/2020

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