Provider Demographics
NPI:1972210383
Name:CAROLINA COMFORT ANGELS LLC
Entity Type:Organization
Organization Name:CAROLINA COMFORT ANGELS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUMPERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-387-8217
Mailing Address - Street 1:303 LOMBARDI CT
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29118-9677
Mailing Address - Country:US
Mailing Address - Phone:303-387-8217
Mailing Address - Fax:303-857-8236
Practice Address - Street 1:303 LOMBARDI CT
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-9677
Practice Address - Country:US
Practice Address - Phone:303-387-8217
Practice Address - Fax:303-857-8236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care