MEDICARE: ARJ SC

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
1	251B00000X	Case Management Agency

Other Identifiers

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

General Provider Information

NPI Number	:	1184087546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARJ SC

Provider Business Mailing Address
First Line	:	1100 S MINT ST STE 107
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28203-4058
Country	:	US
Telephone Number	:	980-819-5692
Fax Number	:	980-819-5694

Provider Business Practice Location Address
First Line	:	1100 S MINT ST STE 107
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28203-4058
Country	:	US
Telephone Number	:	980-819-5692
Fax Number	:	980-819-5694

Authorized Official
Title or Position	:	OWNER
Name	:	ALVIN JASPER
Credential	:
Telephone Number	:	980-229-3788

Provider Enumeration Date	:	04/03/2016
Last Update Date	:	04/03/2016

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Directions to “ARJ SC ” Practice Location

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