Provider Demographics
NPI:1740269141
Name:CAROLINA MEDCARE
Entity type:Organization
Organization Name:CAROLINA MEDCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:M
Authorized Official - Last Name:TURBEVILLE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:843-662-8887
Mailing Address - Street 1:PO BOX 6708
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-6708
Mailing Address - Country:US
Mailing Address - Phone:843-662-8887
Mailing Address - Fax:843-662-9920
Practice Address - Street 1:1322 BROUGHTON BLVD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-6979
Practice Address - Country:US
Practice Address - Phone:843-662-4600
Practice Address - Fax:843-679-0648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-13
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1033416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAB0230Medicaid
SCSB0240Medicaid
SCAB0231Medicaid
SCAB0180Medicaid
SCAB0232Medicaid
SCAB0241Medicaid
SCAB0239Medicaid
SCAB0228Medicaid
SCAB0229Medicaid
SCAB0229Medicaid
SC590012891Medicare PIN