Provider Demographics
NPI:1093468464
Name:ABBEVILLE COUNTY MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:ABBEVILLE COUNTY MEMORIAL HOSPITAL
Other - Org Name:HOMEBRIDGE HOSPICE OF AAMC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-366-3279
Mailing Address - Street 1:PO BOX 887
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29620-0887
Mailing Address - Country:US
Mailing Address - Phone:864-366-3279
Mailing Address - Fax:864-366-3317
Practice Address - Street 1:763 HIGHWAY 28 BYP STE 16
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29620-5596
Practice Address - Country:US
Practice Address - Phone:864-366-0222
Practice Address - Fax:864-366-0223
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABBEVILLE COUNTY MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-27
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based