Provider Demographics
NPI:1760671432
Name:NUCARE CAROLINA AMBULANCE
Entity Type:Organization
Organization Name:NUCARE CAROLINA AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TUNESIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-703-9676
Mailing Address - Street 1:141 SALEM CREEK DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6812
Mailing Address - Country:US
Mailing Address - Phone:336-703-9676
Mailing Address - Fax:336-723-3568
Practice Address - Street 1:141 SALEM CREEK DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-6812
Practice Address - Country:US
Practice Address - Phone:336-723-9676
Practice Address - Fax:336-723-3568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3416L0300X
NC3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0720ROtherBCBS OF NC
NC3406883Medicaid
NC2783082Medicare PIN