Provider Demographics
NPI:1437756467
Name:HOSPICE OF THE UPSTATE INC
Entity Type:Organization
Organization Name:HOSPICE OF THE UPSTATE INC
Other - Org Name:UPSTATE PALLIATIVE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-224-3358
Mailing Address - Street 1:1835 ROGERS ROAD
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-2278
Mailing Address - Country:US
Mailing Address - Phone:864-224-3358
Mailing Address - Fax:864-328-1132
Practice Address - Street 1:1835 ROGERS ROAD
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-2278
Practice Address - Country:US
Practice Address - Phone:864-224-3358
Practice Address - Fax:864-328-1132
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOSPICE OF THE UPSTATE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-02
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCHSP013Medicaid
SCPG1027Medicaid