Provider Demographics
NPI:1013247337
Name:CHC CAP SERVICES
Entity type:Organization
Organization Name:CHC CAP SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:910-671-0006
Mailing Address - Street 1:2406 N ROBERTS AVE
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-2845
Mailing Address - Country:US
Mailing Address - Phone:910-671-0006
Mailing Address - Fax:910-671-0212
Practice Address - Street 1:2406 N ROBERTS AVE
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-2845
Practice Address - Country:US
Practice Address - Phone:910-671-0006
Practice Address - Fax:910-671-0212
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPASSIONATE HOME CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2450251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409616Medicaid