Provider Demographics
NPI:1538255997
Name:CAROLINAS PALLIATIVE CARE AND HOSPICE NETWORK, INC.
Entity type:Organization
Organization Name:CAROLINAS PALLIATIVE CARE AND HOSPICE NETWORK, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
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 1:700 W ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-3437
Mailing Address - Country:US
Mailing Address - Phone:980-993-7300
Mailing Address - Fax:980-993-7397
Practice Address - Street 1:700 W ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-3437
Practice Address - Country:US
Practice Address - Phone:980-993-7300
Practice Address - Fax:980-993-7397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHOS0405251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3401513Medicaid
NC3401513Medicaid
NC3401513Medicaid