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NPI Code Detail

MEDICARE: RAVEN JAMES CRT

MEDICARE: RAVEN JAMES CRT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1227800000XCertified Respiratory TherapistA4294NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2012AGOTHERNCBCBS NC

General Provider Information

NPI Number : 1174741599
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAVEN JAMES CRT
Provider Business Mailing Address
First Line : 700 CROMWELL DR # B
Second Line :
City : GREENVILLE
State : NC
Zip : 27858-5852
Country : US
Telephone Number : 252-830-2094
Fax Number : 252-355-7358
Provider Business Practice Location Address
First Line : 700 CROMWELL DR # B
Second Line :
City : GREENVILLE
State : NC
Zip : 27858-5852
Country : US
Telephone Number : 252-830-2094
Fax Number : 252-355-7358
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2007
Last Update Date : 07/08/2007

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