Provider Demographics
NPI:1275573529
Name:CAROLINA HEALTH CARE, P.A.
Entity Type:Organization
Organization Name:CAROLINA HEALTH CARE, P.A.
Other - Org Name:CAROLINA HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:REMMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-413-3100
Mailing Address - Street 1:506 EAST CHEVES STREET
Mailing Address - Street 2:P. O. BOX 1905
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29503-1905
Mailing Address - Country:US
Mailing Address - Phone:843-413-3100
Mailing Address - Fax:843-413-3197
Practice Address - Street 1:506 EAST CHEVES STREET
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2616
Practice Address - Country:US
Practice Address - Phone:843-413-3100
Practice Address - Fax:843-413-3197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890111PMedicaid
SCPA4110Medicaid
NC890111PMedicaid
SCPA4110Medicaid
SCCE5259Medicare PIN
SC6285Medicare PIN