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General NPI Number Information
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NPI Number | 1134660970
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Entity Type | Organization
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Legal Business Name | CAROLINA AMBULANCE SPECIALTY TRANSPORT, INC.
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Dates
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Enumeration Date | 03/13/2017
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Last Update Date | 08/02/2021
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Provider Practice Location Address
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Address Line | 130 PAUL ED DAIL RD
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City | KENANSVILLE
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State | NC
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Zip | 28349-8512
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Country | US
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Telephone | 910-210-0400
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Fax | 910-338-0303
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Provider Business Mailing Address
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Address Line | PO BOX 524
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City | RICHLANDS
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State | NC
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Zip | 28574-0524
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Country | US
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Telephone | 910-210-0400
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Fax | 910-338-0303
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Authorized Official
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Title or Position | CEO
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Name | STEVEN MARTEN CONRAD
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Credential |
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Telephone | 910-210-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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