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General NPI Number Information
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NPI Number | 1992832869
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Entity Type | Organization
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Legal Business Name | CAROLINA FAMILY CARE, INC
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 01/09/2019
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Provider Practice Location Address
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Address Line | 1600 MIDTOWN AVE
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City | MT PLEASANT
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State | SC
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Zip | 29464-3771
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Country | US
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Telephone | 843-876-8110
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 602108
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City | CHARLOTTE
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State | NC
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Zip | 28260-2108
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Country | US
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Telephone | 843-573-1517
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | KARYN RAE
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Credential |
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Telephone | 843-876-1344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 20-17508
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License Number State | SC
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