Healthcare Provider Details
I. General information
NPI: 1326007857
Provider Name (Legal Business Name): CAROLINA MEDICAL CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2097 HENRY TECKLENBURG DR
CHARLESTON SC
29414-5740
US
IV. Provider business mailing address
2097 HENRY TECKLENBURG DR
CHARLESTON SC
29414-5744
US
V. Phone/Fax
- Phone: 843-852-9777
- Fax: 843-763-3038
- Phone: 843-852-9777
- Fax: 843-763-3038
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
A
SPANDORFER
Title or Position: OWNER
Credential: MD
Phone: 843-852-9777