Healthcare Provider Details

I. General information

NPI: 1659659233
Provider Name (Legal Business Name): CAROLINA RESPIRATORY CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2011
Last Update Date: 07/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 IRON CREEK DR
WASHINGTON NC
27889-8917
US

IV. Provider business mailing address

206 IRON CREEK DR
WASHINGTON NC
27889-8917
US

V. Phone/Fax

Practice location:
  • Phone: 252-833-4428
  • Fax: 252-833-4428
Mailing address:
  • Phone: 252-833-4428
  • Fax: 252-833-4428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER S MODLIN
Title or Position: PRESIDENT
Credential: CRT, RCP
Phone: 252-833-4428