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General NPI Number Information
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NPI Number | 1639304652
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Entity Type | Organization
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Legal Business Name | CAROLINA PROFESSIONAL MANAGEMENT, LLC
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Dates
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Enumeration Date | 05/19/2009
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 4200 MORGANTON RD SUITE 200-10
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-1588
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Country | US
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Telephone | 910-487-0405
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Fax | 910-864-9274
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Provider Business Mailing Address
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Address Line | 4200 MORGANTON RD SUITE 200-10
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-1588
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Country | US
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Telephone | 910-487-0405
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Fax | 910-864-9274
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Authorized Official
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Title or Position | MEMBER-MANAGER
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Name | MR. WAYNE L. WAMPLER
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Credential | MA
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Telephone | 910-487-0405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | HC-3187
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License Number State | NC
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