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General NPI Number Information
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NPI Number | 1760824411
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Entity Type | Organization
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Legal Business Name | SCARAB ENTREPRISES
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Dates
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Enumeration Date | 07/23/2013
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Last Update Date | 07/23/2013
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Provider Practice Location Address
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Address Line | 4220 COUNTY HOME RD
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City | GREENVILLE
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State | NC
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Zip | 27858-7966
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Country | US
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Telephone | 614-558-1077
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Fax |
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Provider Business Mailing Address
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Address Line | 4220 COUNTY HOME RD
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City | GREENVILLE
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State | NC
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Zip | 27858-7966
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPERATOR
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Name | MS. MELONIE R LONG
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Credential | MBA
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Telephone | 614-558-1077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number | TL764258
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License Number State | OH
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