Provider Demographics
NPI:1174671606
Name:BEACON HOSPICE, LLC
Entity Type:Organization
Organization Name:BEACON HOSPICE, LLC
Other - Org Name:HOSPICE OF MT. PLEASANT, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-972-0500
Mailing Address - Street 1:501 WANDO PARK BLVD.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MT. PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464
Mailing Address - Country:US
Mailing Address - Phone:843-972-0500
Mailing Address - Fax:843-973-0501
Practice Address - Street 1:501 WANDO PARK BLVD.
Practice Address - Street 2:SUITE 100
Practice Address - City:MT. PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464
Practice Address - Country:US
Practice Address - Phone:843-972-0500
Practice Address - Fax:843-972-0501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCHPC-113251G00000X
SCHPC-0113251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCHSP090Medicaid
SCHSP090Medicaid
421579Medicare Oscar/Certification