MEDICARE: CAROLINAS MEDICAL CENTER AT HOME LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	3336M0002X	Mail Order Pharmacy
4	333600000X	Pharmacy
5	3336H0001X	Home Infusion Therapy Pharmacy	10319	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2120921	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750517108
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINAS MEDICAL CENTER AT HOME LLC

Provider Business Mailing Address
First Line	:	PO BOX 602262
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-2262
Country	:	US
Telephone Number	:	704-512-5333
Fax Number	:	704-561-8580

Provider Business Practice Location Address
First Line	:	1701 ABBEY PL
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28209-3733
Country	:	US
Telephone Number	:	704-512-5333
Fax Number	:	704-561-8580

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHAEL ANTHONY STOLZEBACH
Credential	:
Telephone Number	:	704-591-2576

Provider Enumeration Date	:	05/29/2009
Last Update Date	:	12/03/2025

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