Provider Demographics
NPI:1073538906
Name:TMC HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:TMC HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:CREWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-812-9580
Mailing Address - Street 1:100 PROFESSIONAL PL STE 305
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-3872
Mailing Address - Country:US
Mailing Address - Phone:770-812-8614
Mailing Address - Fax:770-812-8372
Practice Address - Street 1:150 HENRY BURSON AVE STE 102
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-4408
Practice Address - Country:US
Practice Address - Phone:770-834-5438
Practice Address - Fax:770-834-8956
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TANNER MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-13
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA11-15-34251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
111534Medicare Oscar/Certification