Provider Demographics
NPI:1639304652
Name:CAROLINA PROFESSIONAL MANAGEMENT, LLC
Entity Type:Organization
Organization Name:CAROLINA PROFESSIONAL MANAGEMENT, LLC
Other - Org Name:AMERICARE HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER-MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:L
Authorized Official - Last Name:WAMPLER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:910-487-0405
Mailing Address - Street 1:4200 MORGANTON RD
Mailing Address - Street 2:SUITE 200-10
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-1588
Mailing Address - Country:US
Mailing Address - Phone:910-487-0405
Mailing Address - Fax:910-864-9274
Practice Address - Street 1:4200 MORGANTON RD
Practice Address - Street 2:SUITE 200-10
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-1588
Practice Address - Country:US
Practice Address - Phone:910-487-0405
Practice Address - Fax:910-864-9274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-19
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC-3187253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care