Provider Demographics
NPI:1669918595
Name:CAROLINA CARE SOLUTIONS AND ASSOCIATES LLC
Entity type:Organization
Organization Name:CAROLINA CARE SOLUTIONS AND ASSOCIATES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EZEKIEL
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:PEAY
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:704-989-0994
Mailing Address - Street 1:2633 BEULAH CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28104-9211
Mailing Address - Country:US
Mailing Address - Phone:704-989-0994
Mailing Address - Fax:
Practice Address - Street 1:1000 VAN BUREN AVE
Practice Address - Street 2:SUITE E
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079-5618
Practice Address - Country:US
Practice Address - Phone:704-989-0994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)