Healthcare Provider Details

I. General information

NPI: 1992861736
Provider Name (Legal Business Name): ET CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 02/05/2020
Certification Date: 02/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 22ND STREET PL SE
HICKORY NC
28602-8321
US

IV. Provider business mailing address

PO BOX 1289
HICKORY NC
28603
US

V. Phone/Fax

Practice location:
  • Phone: 910-521-5550
  • Fax: 910-521-3335
Mailing address:
  • Phone: 910-521-5550
  • Fax: 910-521-3335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BD1200X
TaxonomyDialysis Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number455
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number02015
License Number StateNC
# 6
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VII. Legacy identifiers

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

# 1
Identifier02202
Identifier TypeOTHER
Identifier StateNC
Identifier IssuerBOARD OF PHARMACY PERMIT
# 2
Identifier026895
Identifier TypeOTHER
Identifier State
Identifier IssuerTHE COMPLIANCE TEAM
# 3
Identifier3408119
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer
# 4
Identifier7703051
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name: MORGAN LEE STARNES
Title or Position: PRACTICE MANAGER
Credential:
Phone: 910-521-5550