Provider Demographics
NPI:1699501593
Name:CAROLINA HEALTH MEDICAL TRANSPORTATION LLC
Entity type:Organization
Organization Name:CAROLINA HEALTH MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:PETTIFORD
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:919-599-0705
Mailing Address - Street 1:2223 E NC HIGHWAY 54 STE O
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-5234
Mailing Address - Country:US
Mailing Address - Phone:919-599-0705
Mailing Address - Fax:
Practice Address - Street 1:2223 E NC HIGHWAY 54 STE O
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-5234
Practice Address - Country:US
Practice Address - Phone:919-599-0705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response AttendantGroup - Multi-Specialty