Provider Demographics
NPI:1083738843
Name:CAROLINA NURSING SERVICES
Entity Type:Organization
Organization Name:CAROLINA NURSING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:AMY
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-443-6800
Mailing Address - Street 1:3204 SUNSET AVE STE C
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-3588
Mailing Address - Country:US
Mailing Address - Phone:252-443-6800
Mailing Address - Fax:252-443-7101
Practice Address - Street 1:3204 SUNSET AVE STE C
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-3588
Practice Address - Country:US
Practice Address - Phone:252-443-6800
Practice Address - Fax:252-443-7101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC1471251B00000X, 251E00000X, 251J00000X, 253Z00000X, 332B00000X, 332U00000X, 333300000X, 385H00000X
NCHC4333251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332U00000XSuppliersHome Delivered Meals
No333300000XSuppliersEmergency Response System Companies
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7100319Medicaid
NC3409188Medicaid
NC6600695Medicaid
NC6602276Medicaid