Provider Demographics
NPI:1134660970
Name:CAROLINA AMBULANCE SPECIALTY TRANSPORT, INC.
Entity Type:Organization
Organization Name:CAROLINA AMBULANCE SPECIALTY TRANSPORT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:MARTEN
Authorized Official - Last Name:CONRAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-210-0400
Mailing Address - Street 1:PO BOX 524
Mailing Address - Street 2:
Mailing Address - City:RICHLANDS
Mailing Address - State:NC
Mailing Address - Zip Code:28574-0524
Mailing Address - Country:US
Mailing Address - Phone:910-210-0400
Mailing Address - Fax:910-338-0303
Practice Address - Street 1:130 PAUL ED DAIL RD
Practice Address - Street 2:
Practice Address - City:KENANSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28349-8512
Practice Address - Country:US
Practice Address - Phone:910-210-0400
Practice Address - Fax:910-338-0303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-13
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)