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General NPI Number Information
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NPI Number | 1215803606
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Entity Type | Organization
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Legal Business Name |
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Dates
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Enumeration Date | 10/14/2025
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 216 NEWKIRK RD
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City | BURGAW
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State | NC
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Zip | 28425-2636
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Country | US
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Telephone | 910-300-6128
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Fax | 910-300-6128
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Provider Business Mailing Address
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Address Line | 216 NEWKIRK RD
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City | BURGAW
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State | NC
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Zip | 28425-2636
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Country | US
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Telephone | 910-300-6128
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Fax | 910-300-6128
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Authorized Official
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Title or Position | ADMINISTATOR/ OWNER
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Name | CAROLYN DENISE CARR-GREEN
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Credential |
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Telephone | 910-300-6128
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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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