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General NPI Number Information
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NPI Number | 1215944343
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Entity Type | Organization
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Legal Business Name | CAROLINA HOMECARE MED EQ CTR INC
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 03/21/2008
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Provider Practice Location Address
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Address Line | 1136 GROVE RD
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City | GREENVILLE
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State | SC
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Zip | 29605-4620
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Country | US
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Telephone | 864-271-8258
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Fax | 864-235-0523
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Provider Business Mailing Address
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Address Line | 1136 GROVE RD
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City | GREENVILLE
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State | SC
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Zip | 29605-4620
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Country | US
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Telephone | 864-271-8258
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Fax | 864-235-0523
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JACKIE BOLT
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Credential |
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Telephone | 864-271-8258
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State | SC
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