Provider Demographics
NPI:1104567247
Name:CARTERS CARE
Entity type:Organization
Organization Name:CARTERS CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEXTER
Authorized Official - Middle Name:ARMOND
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-254-9170
Mailing Address - Street 1:85 BANK ST
Mailing Address - Street 2:
Mailing Address - City:STEVENSON
Mailing Address - State:AL
Mailing Address - Zip Code:35772-3781
Mailing Address - Country:US
Mailing Address - Phone:256-254-9170
Mailing Address - Fax:
Practice Address - Street 1:85 BANK ST
Practice Address - Street 2:
Practice Address - City:STEVENSON
Practice Address - State:AL
Practice Address - Zip Code:35772-3781
Practice Address - Country:US
Practice Address - Phone:256-254-9170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONVACARE SERVICES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL902486723Medicaid
AL8363390Medicaid
AL87-0982642Medicaid