Provider Demographics
NPI:1629036629
Name:CAROLINA HEALTH FORCE
Entity Type:Organization
Organization Name:CAROLINA HEALTH FORCE
Other - Org Name:MUMFORD INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MUMFORD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:843-556-2784
Mailing Address - Street 1:681 ORLEANS RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-5750
Mailing Address - Country:US
Mailing Address - Phone:843-556-2784
Mailing Address - Fax:843-556-1320
Practice Address - Street 1:681 ORLEANS RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-5750
Practice Address - Country:US
Practice Address - Phone:843-556-2784
Practice Address - Fax:843-556-1320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEX0326Medicaid