{
"Npi": {
"NPI": "1750337044",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CAROLINA HEALTHCARE PRODUCTS, INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "20 MEDICAL CAMPUS DR",
"SecondLineMailingAddress": "SUITE 102",
"MailingAddressCityName": "SUPPLY",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28462-4094",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "910-755-6767",
"MailingAddressFaxNumber": "910-755-6769",
"FirstLinePracticeLocationAddress": "20 MEDICAL CAMPUS DR",
"SecondLinePracticeLocationAddress": "SUITE 102",
"PracticeLocationAddressCityName": "SUPPLY",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "28462-4094",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "910-755-6767",
"PracticeLocationAddressFaxNumber": "910-755-6769",
"EnumerationDate": "05/26/2006",
"LastUpdateDate": "02/13/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DE SANTO",
"AuthorizedOfficialFirstName": "RON",
"AuthorizedOfficialMiddleName": "J",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "C.PED.",
"AuthorizedOfficialTelephoneNumber": "910-454-4545",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "01087",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}