Healthcare Provider Details

I. General information

NPI: 1063671436
Provider Name (Legal Business Name): CAROLINA GENERATORS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2008
Last Update Date: 06/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9699 W PINE ST
LOWGAP NC
27024-7130
US

IV. Provider business mailing address

489 N WILSON RD
LOWGAP NC
27024-7440
US

V. Phone/Fax

Practice location:
  • Phone: 336-352-3999
  • Fax: 336-352-3999
Mailing address:
  • Phone: 336-352-3999
  • Fax: 336-352-3999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License Number600481616
License Number StateNC

VIII. Authorized Official

Name: MR. BRAD HARRISON I
Title or Position: OWNER
Credential:
Phone: 336-352-3999