1326402918 NPI number — MR. HAROLD RAY CARRIER III LPCA

Table of content: MR. HAROLD RAY CARRIER III LPCA (NPI 1326402918)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326402918 NPI number — MR. HAROLD RAY CARRIER III LPCA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARRIER
Provider First Name:
HAROLD
Provider Middle Name:
RAY
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
III
Provider Credential Text:
LPCA
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326402918
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/21/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
71 CAVALIER BLVD
Provider Second Line Business Mailing Address:
SUITE 325
Provider Business Mailing Address City Name:
FLORENCE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41042-5121
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-474-2777
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
71 CAVALIER BLVD
Provider Second Line Business Practice Location Address:
SUITE 325
Provider Business Practice Location Address City Name:
FLORENCE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41042-5121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-474-2777
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/08/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  LPCCCA00223125 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 21751127 . This is a "LAST FOUR OF SOCIAL SECURITY NUMBER AND FIRST FOUR NUMBERS OF BIRTHDAY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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