Provider Demographics
NPI:1962001529
Name:CARETEAM, LLC
Entity Type:Organization
Organization Name:CARETEAM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:THEODORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-729-0316
Mailing Address - Street 1:PO BOX 1875
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29465-1875
Mailing Address - Country:US
Mailing Address - Phone:843-469-1744
Mailing Address - Fax:
Practice Address - Street 1:1330 AMHERST ST STE E
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3054
Practice Address - Country:US
Practice Address - Phone:540-773-8517
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty