Healthcare Provider Details

I. General information

NPI: 1982911525
Provider Name (Legal Business Name): CAROLINA RAMPS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2010
Last Update Date: 09/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 SW 102ND DR
DAVIE FL
33324-7602
US

IV. Provider business mailing address

2400 SW 102ND DR
DAVIE FL
33324-7602
US

V. Phone/Fax

Practice location:
  • Phone: 704-771-2921
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberCS029015
License Number StateMA

VIII. Authorized Official

Name: JASON SOMERVILLE
Title or Position: OWNER/MANAGER
Credential:
Phone: 704-771-2921