Provider Demographics
NPI:1245562735
Name:CAROLINAS MEDICAL CENTER AT HOME, LLC
Entity Type:Organization
Organization Name:CAROLINAS MEDICAL CENTER AT HOME, LLC
Other - Org Name:HEALTHY @ HOME - BLUE RIDGE HEALTHCARE LIFELINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:HARRIETT
Authorized Official - Middle Name:C
Authorized Official - Last Name:SARTAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-512-5231
Mailing Address - Street 1:PO BOX 32861
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28232-2861
Mailing Address - Country:US
Mailing Address - Phone:704-512-5231
Mailing Address - Fax:704-512-2428
Practice Address - Street 1:201 SAINT GERMAIN AVE SW
Practice Address - Street 2:
Practice Address - City:VALDESE
Practice Address - State:NC
Practice Address - Zip Code:28690-2744
Practice Address - Country:US
Practice Address - Phone:828-580-6641
Practice Address - Fax:828-580-6449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies