Provider Demographics
NPI:1710448329
Name:BLUEDOT CARES
Entity Type:Organization
Organization Name:BLUEDOT CARES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:CLONARIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-241-1116
Mailing Address - Street 1:2915 WHITEHALL PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-3433
Mailing Address - Country:US
Mailing Address - Phone:704-247-8725
Mailing Address - Fax:
Practice Address - Street 1:2915 WHITEHALL PARK DR STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-3433
Practice Address - Country:US
Practice Address - Phone:704-247-8725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-27
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care