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General NPI Number Information
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NPI Number | 1679623193
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Entity Type | Organization
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Legal Business Name | CARROLTON HOME CARE INCORPORATED
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 216 BEAMAN ST
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City | CLINTON
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State | NC
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Zip | 28328-2906
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Country | US
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Telephone | 252-467-1393
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Fax | 252-937-2647
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Provider Business Mailing Address
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Address Line | 800 TIFFANY BLVD
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-1946
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Country | US
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Telephone | 252-467-1393
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Fax | 252-937-2647
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Authorized Official
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Title or Position | VICE PRESIDENT LEGAL SERVICES
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Name | MICHAEL HALE
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Credential | P.A, R.N.
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Telephone | 252-467-1389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Legacy Identifiers
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Identifier #1
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Identifier Code | 8700325
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Identifier Type | MEDICAID
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Identifier State | NC
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Identifier Issuer |
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Proprietary Identifiers Ever Reported
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Identifier #1
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Identifier Code | 8700325
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Identifier Type | MEDICAID
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Identifier State | NC
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Identifier Issuer |
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