Provider Demographics
NPI:1962250845
Name:CAROLINA RELIABLE HOME CARE LLC
Entity type:Organization
Organization Name:CAROLINA RELIABLE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PASCHA
Authorized Official - Middle Name:TARMARA
Authorized Official - Last Name:COKELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-251-2753
Mailing Address - Street 1:203 W MAIN ST STE G11
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-2670
Mailing Address - Country:US
Mailing Address - Phone:803-399-1919
Mailing Address - Fax:
Practice Address - Street 1:203 W MAIN ST STE G11
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-2670
Practice Address - Country:US
Practice Address - Phone:803-399-1919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care