Provider Demographics
NPI:1083738843
Name:CAROLINA NURSING SERVICES
Entity type:Organization
Organization Name:CAROLINA NURSING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:AMY
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-443-6800
Mailing Address - Street 1:3204 SUNSET AVE STE C
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-3588
Mailing Address - Country:US
Mailing Address - Phone:252-443-6800
Mailing Address - Fax:252-443-7101
Practice Address - Street 1:3204 SUNSET AVE STE C
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-3588
Practice Address - Country:US
Practice Address - Phone:252-443-6800
Practice Address - Fax:252-443-7101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC1471251E00000X, 251J00000X, 251B00000X, 385H00000X, 332B00000X, 332U00000X, 333300000X, 253Z00000X
NCHC4333251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No251B00000XAgenciesCase Management
No385H00000XRespite Care FacilityRespite Care
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332U00000XSuppliersHome Delivered Meals
No333300000XSuppliersEmergency Response System Companies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7100319Medicaid
NC3409188Medicaid
NC6600695Medicaid
NC6602276Medicaid