=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699767681
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CAROLINA'S HOME CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/17/2005
-----------------------------------------------------
Last Update Date | 04/06/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 224 MAIN ST W
-----------------------------------------------------
City | AHOSKIE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27910-3318
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-332-7754
-----------------------------------------------------
Fax | 252-332-7644
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1066
-----------------------------------------------------
City | AHOSKIE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27910-1066
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-332-7754
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. KAREN B ROWE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 252-332-7754
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | HC2383
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | HC2069
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | HC2428
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | HC1848
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------