Provider Demographics
NPI:1649392523
Name:CAROLINA EAST HOME CARE & HOSPICE, INC
Entity Type:Organization
Organization Name:CAROLINA EAST HOME CARE & HOSPICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:S
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:910-296-0819
Mailing Address - Street 1:401 N MAIN STREET
Mailing Address - Street 2:PO BOX 887
Mailing Address - City:KENANSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28349-0887
Mailing Address - Country:US
Mailing Address - Phone:910-296-0819
Mailing Address - Fax:910-296-0842
Practice Address - Street 1:401 N MAIN STREET
Practice Address - Street 2:
Practice Address - City:KENANSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28349-0887
Practice Address - Country:US
Practice Address - Phone:910-296-0819
Practice Address - Fax:910-296-0842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC0053251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3417063Medicaid