Healthcare Provider Details
I. General information
NPI: 1215229083
Provider Name (Legal Business Name): CAROLINA HOME MEDICAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/11/2011
Last Update Date: 09/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11326 NC HWY 55 EAST
GRANTSBORO NC
28529
US
IV. Provider business mailing address
1301 COMMERCE DR
NEW BERN NC
28562-2213
US
V. Phone/Fax
- Phone: 252-745-2012
- Fax: 252-745-6535
- Phone: 252-639-9006
- Fax: 252-639-9005
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | 01732 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333300000X |
| Taxonomy | Emergency Response System Companies |
| License Number | 01732 |
| License Number State | NC |
VIII. Authorized Official
Name: MR.
ROBERT
JOSEPH
MCLAUGHLIN
JR.
Title or Position: PRESIDENT
Credential:
Phone: 252-514-0461