| Organization Name: | CAROLINA VITAL CARE, INC. |
| NPI Number: | 1790788057 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JERRY A. STANLEY (CHIEF OPERATING OFFICER) |
| Mailing Address: | 706 W Corbett Ave Suite B Swansboro |
| State: | NC US |
| Postal Code: | 285848452 |
| Phone Number: | 9103267948 |
| Fax Number: | 9103265480 |
| NPI Enumeration Date: | 05/31/2005 |
| NPI Last Update Date: | 10/09/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BX2000X |
| License Number: | HC1403 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Oxygen Equipment & Supplies |
| Taxonomy Definition: | |