Provider Demographics
NPI:1689901936
Name:OCEANIC INFINITE CARE CORPORATION
Entity Type:Organization
Organization Name:OCEANIC INFINITE CARE CORPORATION
Other - Org Name:OIHC/OCEANIC INFINITE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-842-2011
Mailing Address - Street 1:2852D OLD FERRY RD SW
Mailing Address - Street 2:
Mailing Address - City:HOLDEN BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28462-2258
Mailing Address - Country:US
Mailing Address - Phone:910-842-2011
Mailing Address - Fax:866-432-0035
Practice Address - Street 1:2852D OLD FERRY RD SW
Practice Address - Street 2:
Practice Address - City:HOLDEN BEACH
Practice Address - State:NC
Practice Address - Zip Code:28462-2258
Practice Address - Country:US
Practice Address - Phone:910-842-2011
Practice Address - Fax:866-432-0035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-06
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3931251F00000X, 251J00000X, 253Z00000X, 372600000X, 3747P1801X, 376K00000X
NC261QA0600X, 261QH0100X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day CareGroup - Single Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Single Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418622Medicaid
NC6601918Medicaid