Provider Demographics
NPI:1851047781
Name:CAROLINA HEALTH SERVICES
Entity Type:Organization
Organization Name:CAROLINA HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HOTEESHAA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:CORNISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-477-2817
Mailing Address - Street 1:800 OLD WHITEVILLE RD LOT 47
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-8205
Mailing Address - Country:US
Mailing Address - Phone:443-477-2817
Mailing Address - Fax:
Practice Address - Street 1:800 OLD WHITEVILLE RD LOT 47
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-8205
Practice Address - Country:US
Practice Address - Phone:443-477-2817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty