Provider Demographics
NPI:1831337989
Name:CAROLINA'S HOME CARE INC
Entity type:Organization
Organization Name:CAROLINA'S HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:P
Authorized Official - Last Name:LARSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-332-7754
Mailing Address - Street 1:PO BOX 1066
Mailing Address - Street 2:
Mailing Address - City:AHOSKIE
Mailing Address - State:NC
Mailing Address - Zip Code:27910-1066
Mailing Address - Country:US
Mailing Address - Phone:252-332-7754
Mailing Address - Fax:252-332-7644
Practice Address - Street 1:224 MAIN ST W
Practice Address - Street 2:
Practice Address - City:AHOSKIE
Practice Address - State:NC
Practice Address - Zip Code:27910-3318
Practice Address - Country:US
Practice Address - Phone:252-332-7754
Practice Address - Fax:252-332-7644
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAROLINA'S HOME CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-28
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC1848251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409182Medicaid