Provider Demographics
NPI:1629025283
Name:CAROLINA HEALTHCARE PRODUCTS, INC
Entity Type:Organization
Organization Name:CAROLINA HEALTHCARE PRODUCTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RON
Authorized Official - Middle Name:J
Authorized Official - Last Name:DE SANTO
Authorized Official - Suffix:
Authorized Official - Credentials:C PED
Authorized Official - Phone:910-454-4545
Mailing Address - Street 1:1635 N HOWE ST
Mailing Address - Street 2:STE H
Mailing Address - City:SOUTHPORT
Mailing Address - State:NC
Mailing Address - Zip Code:28461-8372
Mailing Address - Country:US
Mailing Address - Phone:910-454-4545
Mailing Address - Fax:910-454-0122
Practice Address - Street 1:1635 N HOWE ST
Practice Address - Street 2:STE H
Practice Address - City:SOUTHPORT
Practice Address - State:NC
Practice Address - Zip Code:28461-8372
Practice Address - Country:US
Practice Address - Phone:910-454-4545
Practice Address - Fax:910-454-0122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC00730332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7703813Medicaid
NC7703813Medicaid