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General NPI Number Information
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NPI Number | 1679676688
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Entity Type | Organization
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Legal Business Name | CAROLINA HEALTH CARE, INC.
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 02/29/2008
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Provider Practice Location Address
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Address Line | 2408 TWO NOTCH RD 2408 TWO NOTCH ROAD
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City | COLUMBIA
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State | SC
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Zip | 29204-2227
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Country | US
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Telephone | 803-256-2728
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Fax | 803-765-1644
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Provider Business Mailing Address
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Address Line | 2408 TWO NOTCH RD P.O. BOX 8051
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City | COLUMBIA
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State | SC
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Zip | 29204-2227
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Country | US
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Telephone | 803-256-2728
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Fax | 803-765-1644
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. JEIRLINE B JONES
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Credential | RN
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Telephone | 803-256-2728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 13404
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License Number State | SC
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