Provider Demographics
NPI:1477602803
Name:CAROLINAS ALFA RAM, INC.
Entity Type:Organization
Organization Name:CAROLINAS ALFA RAM, INC.
Other - Org Name:CAR HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:WANDADARIL
Authorized Official - Middle Name:GALE
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:AAS
Authorized Official - Phone:704-864-7727
Mailing Address - Street 1:175 W MAIN AVE
Mailing Address - Street 2:STE. A
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28052-4135
Mailing Address - Country:US
Mailing Address - Phone:704-864-7727
Mailing Address - Fax:
Practice Address - Street 1:175 W MAIN AVE
Practice Address - Street 2:STE. A
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28052-4135
Practice Address - Country:US
Practice Address - Phone:704-864-7727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3649251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCHC3649OtherNC DEPT. OF HEALTH AND HU