MEDICARE: CAROLYNS CHOICE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	36108012	NC

General Provider Information

NPI Number	:	1386133163
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLYNS CHOICE

Provider Business Mailing Address
First Line	:	1215 WATER ST
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27405-4923
Country	:	US
Telephone Number	:	336-437-4160
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 CENTERVIEW DR STE 41
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27407-3708
Country	:	US
Telephone Number	:	336-437-4160
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. SHANETRA W SLADE
Credential	:	CNA II
Telephone Number	:	336-437-4160

Provider Enumeration Date	:	05/07/2018
Last Update Date	:	05/07/2018

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Directions to “CAROLYNS CHOICE ” Practice Location

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