Provider Demographics
NPI:1689757551
Name:CAREERMED ALLIANCE, INC.
Entity Type:Organization
Organization Name:CAREERMED ALLIANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-758-2997
Mailing Address - Street 1:1713 TAYLOR ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-3400
Mailing Address - Country:US
Mailing Address - Phone:803-758-2997
Mailing Address - Fax:803-256-5011
Practice Address - Street 1:1713 TAYLOR ST
Practice Address - Street 2:SUITE D
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-3400
Practice Address - Country:US
Practice Address - Phone:803-758-2997
Practice Address - Fax:803-256-5011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0689889302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization