Healthcare Provider Details

I. General information

NPI: 1720100498
Provider Name (Legal Business Name): CAROLINA EAST HOME CARE & HOSPICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N MAIN STREET
KENANSVILLE NC
28349-0887
US

IV. Provider business mailing address

PO BOX 887
KENANSVILLE NC
28349-0887
US

V. Phone/Fax

Practice location:
  • Phone: 910-296-0819
  • Fax: 910-296-0482
Mailing address:
  • Phone: 910-296-0819
  • Fax: 910-296-0482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberHOS0053
License Number StateNC

VIII. Authorized Official

Name: MS. LYNN S HARDY
Title or Position: EXECUTIVE DIRECTOR
Credential: RN
Phone: 910-296-0819