Healthcare Provider Details

I. General information

NPI: 1356269864
Provider Name (Legal Business Name): CAROLINA HOMECARE GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6640 W WILKINSON BLVD STE 200
BELMONT NC
28012-2796
US

IV. Provider business mailing address

3466 HENDERSON DR STE 27
JACKSONVILLE NC
28546-5232
US

V. Phone/Fax

Practice location:
  • Phone: 980-890-7457
  • Fax: 980-514-3101
Mailing address:
  • Phone: 910-729-6392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: IRMEEN M ASHRAF
Title or Position: CEO
Credential:
Phone: 510-579-8332