Provider Demographics
NPI:1114925369
Name:HOSPICE OF CHARLESTON, INC.
Entity Type:Organization
Organization Name:HOSPICE OF CHARLESTON, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OUTCOMES MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:WISE
Authorized Official - Last Name:RINEHART
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:843-529-3100
Mailing Address - Street 1:3870 LEEDS AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-7493
Mailing Address - Country:US
Mailing Address - Phone:843-529-3100
Mailing Address - Fax:843-266-3489
Practice Address - Street 1:3870 LEEDS AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-7493
Practice Address - Country:US
Practice Address - Phone:843-529-3100
Practice Address - Fax:843-266-3489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCHPC-007251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCHSP003Medicaid
SC421503Medicare ID - Type UnspecifiedMEDICARE HOSPICE PROVIDER