Provider Demographics
NPI:1912447996
Name:CAROLINAS MEDICAL CENTER AT HOME, LLC
Entity type:Organization
Organization Name:CAROLINAS MEDICAL CENTER AT HOME, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:STOLZENBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-512-2312
Mailing Address - Street 1:PO BOX 602259
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2259
Mailing Address - Country:US
Mailing Address - Phone:888-670-1213
Mailing Address - Fax:
Practice Address - Street 1:226 NORTHPARK DRIVE
Practice Address - Street 2:SUITE 120
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730
Practice Address - Country:US
Practice Address - Phone:704-512-2308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-24
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health