Provider Demographics
NPI:1447420864
Name:MID-CAROLINA HOMECARE SPECIALISTS
Entity Type:Organization
Organization Name:MID-CAROLINA HOMECARE SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REIMBURSEMENT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DESIREE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:919-460-2582
Mailing Address - Street 1:600 AIRPORT BLVD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8489
Mailing Address - Country:US
Mailing Address - Phone:919-465-9300
Mailing Address - Fax:
Practice Address - Street 1:600 AIRPORT BLVD
Practice Address - Street 2:SUITE 500
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-8489
Practice Address - Country:US
Practice Address - Phone:919-465-9300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC1801332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7703063Medicaid
NC0448VOtherBC/BS OF NC
NC7703063Medicaid
NC=========OtherMEDCOST
NC0448VOtherBC/BS OF NC