Provider Demographics
NPI:1356890214
Name:CAROLINAS HOMETOWN RESPIRATORY LLC
Entity type:Organization
Organization Name:CAROLINAS HOMETOWN RESPIRATORY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:DINNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-770-5248
Mailing Address - Street 1:371 CONCORD PKWY N
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-6734
Mailing Address - Country:US
Mailing Address - Phone:888-217-2201
Mailing Address - Fax:704-793-1610
Practice Address - Street 1:371 CONCORD PKWY N
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-6734
Practice Address - Country:US
Practice Address - Phone:888-877-0202
Practice Address - Fax:866-487-0202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-03
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
NC02398332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC02398OtherNC BOARD OF PHARMACY PERMIT
NC02398OtherNC BOARD OF PHARMACY PERMIT