Provider Demographics
NPI:1528010931
Name:CAROLINA MED-PLUS INC
Entity Type:Organization
Organization Name:CAROLINA MED-PLUS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:E
Authorized Official - Last Name:STANFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-572-1681
Mailing Address - Street 1:349 I COPPERFIELD BLVD
Mailing Address - Street 2:349 I COPPERFIELD BLVD
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-2432
Mailing Address - Country:US
Mailing Address - Phone:704-782-4338
Mailing Address - Fax:704-782-6511
Practice Address - Street 1:349 I COPPERFIELD BLVD
Practice Address - Street 2:349 I COPPERFIELD BLVD
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2432
Practice Address - Country:US
Practice Address - Phone:704-782-4338
Practice Address - Fax:704-782-6511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7703797Medicaid
4739000001Medicare ID - Type Unspecified