Provider Demographics
NPI:1174594592
Name:CLAYTON AREA RESCUE, INC
Entity type:Organization
Organization Name:CLAYTON AREA RESCUE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CANGEMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-553-5493
Mailing Address - Street 1:PO BOX 45
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27528-0045
Mailing Address - Country:US
Mailing Address - Phone:919-553-5493
Mailing Address - Fax:919-553-3806
Practice Address - Street 1:317 S ROBERTSON ST
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-2346
Practice Address - Country:US
Practice Address - Phone:919-553-5493
Practice Address - Fax:919-553-3806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-01
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11253416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0722AOtherBLUE CROSS/BLUE SHIELD
NC15826OtherCONVENTRY HEALTH/WELLPATH
NCA2856OtherEMPIRE
NC0722AOtherNC TEACHERS AND STATE EMP
NC3409908Medicaid
NC237729OtherLIBERTY MUTUAL
NC0005814058OtherAETNA
NC=========001OtherTRICARE
NC0722AOtherBLUE CROSS/BLUE SHIELD