Provider Demographics
NPI:1699828087
Name:CAROLINA CHOICE LLC
Entity Type:Organization
Organization Name:CAROLINA CHOICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-633-3855
Mailing Address - Street 1:2117 S GLENBURNIE RD
Mailing Address - Street 2:SUITE 17 & 18
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-2239
Mailing Address - Country:US
Mailing Address - Phone:252-633-3855
Mailing Address - Fax:252-633-1548
Practice Address - Street 1:2117 S GLENBURNIE RD
Practice Address - Street 2:SUITE 17 & 18
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-2239
Practice Address - Country:US
Practice Address - Phone:252-633-3855
Practice Address - Fax:252-633-1548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6603292Medicaid
NC6603294Medicaid
NC8300923Medicaid
NC6603380Medicaid
NC8300485Medicaid
NC8301024Medicaid
NC8301192Medicaid
NC8300912Medicaid