Provider Demographics
NPI:1437842283
Name:CARE MEDICAL SUPPLY, INC
Entity Type:Organization
Organization Name:CARE MEDICAL SUPPLY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RUSTY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:MISENHEIMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-673-9356
Mailing Address - Street 1:1620 S MLK JR AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-5595
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1620 S MLK JR AVE STE 105
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-5595
Practice Address - Country:US
Practice Address - Phone:678-673-9356
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-30
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC40437610Medicaid