Provider Demographics
NPI:1689771768
Name:CAROLINA HEALTHCARE CONSULTANTS, INC
Entity Type:Organization
Organization Name:CAROLINA HEALTHCARE CONSULTANTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VERNIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HALTIWANGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-739-2600
Mailing Address - Street 1:125 QUEEN PKWY STE D
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-4676
Mailing Address - Country:US
Mailing Address - Phone:803-739-2600
Mailing Address - Fax:
Practice Address - Street 1:125 QUEEN PKWY STE D
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-4676
Practice Address - Country:US
Practice Address - Phone:803-739-2600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDME 994Medicaid
SCDME 994Medicaid