Healthcare Provider Details

I. General information

NPI: 1154378016
Provider Name (Legal Business Name): CAROLINA MOBILITY & SEATING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 08/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 AMERICAN WAY
APEX NC
27502
US

IV. Provider business mailing address

1001 AMERICAN WAY
APEX NC
27502-7700
US

V. Phone/Fax

Practice location:
  • Phone: 919-303-0902
  • Fax: 919-303-9866
Mailing address:
  • Phone: 919-303-0902
  • Fax: 919-303-9866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number00303
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier7702255
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name: MR. MELICK B ELLIOTT
Title or Position: PRESIDENT OWNER
Credential:
Phone: 919-303-0902