Provider Demographics
NPI:1992861736
Name:ET CARE INC
Entity type:Organization
Organization Name:ET CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:STARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-521-5550
Mailing Address - Street 1:PO BOX 1289
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28603
Mailing Address - Country:US
Mailing Address - Phone:910-521-5550
Mailing Address - Fax:910-521-3335
Practice Address - Street 1:826 22ND STREET PL SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-8321
Practice Address - Country:US
Practice Address - Phone:910-521-5550
Practice Address - Fax:910-521-3335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 332BC3200X, 332BD1200X, 332BP3500X
NC455332BX2000X
NC02015332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC02202OtherBOARD OF PHARMACY PERMIT
026895OtherTHE COMPLIANCE TEAM
NC3408119Medicaid
NC7703051Medicaid