Provider Demographics
NPI:1386686608
Name:CARTER'S MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:CARTER'S MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:910-618-0445
Mailing Address - Street 1:3644 ROZIER SIDING RD.
Mailing Address - Street 2:
Mailing Address - City:ST. PAULS
Mailing Address - State:NC
Mailing Address - Zip Code:28384-6953
Mailing Address - Country:US
Mailing Address - Phone:910-618-0445
Mailing Address - Fax:910-618-0455
Practice Address - Street 1:4908 BARKER TEN MILE RD
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-0137
Practice Address - Country:US
Practice Address - Phone:910-618-0445
Practice Address - Fax:910-618-0455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2007-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
4738460001Medicare NSC