Provider Demographics
NPI:1245950260
Name:MCCARROLL, CARLOS D
Entity type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:D
Last Name:MCCARROLL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1034 RYDALE RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-1510
Mailing Address - Country:US
Mailing Address - Phone:573-855-5171
Mailing Address - Fax:
Practice Address - Street 1:1034 RYDALE RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-1510
Practice Address - Country:US
Practice Address - Phone:573-855-5171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)