Provider Demographics
NPI:1679676688
Name:CAROLINA HEALTH CARE, INC.
Entity type:Organization
Organization Name:CAROLINA HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEIRLINE
Authorized Official - Middle Name:B
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:803-256-2728
Mailing Address - Street 1:2408 TWO NOTCH RD
Mailing Address - Street 2:P.O. BOX 8051
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-2227
Mailing Address - Country:US
Mailing Address - Phone:803-256-2728
Mailing Address - Fax:803-765-1644
Practice Address - Street 1:2408 TWO NOTCH RD
Practice Address - Street 2:2408 TWO NOTCH ROAD
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-2227
Practice Address - Country:US
Practice Address - Phone:803-256-2728
Practice Address - Fax:803-765-1644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13404251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care