Provider Demographics
NPI:1518117308
Name:HOSPICE OF SCOTLAND COUNTY, INC
Entity Type:Organization
Organization Name:HOSPICE OF SCOTLAND COUNTY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:MISSY
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN
Authorized Official - Phone:910-276-7176
Mailing Address - Street 1:610 LAUCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28352-5509
Mailing Address - Country:US
Mailing Address - Phone:910-276-7176
Mailing Address - Fax:910-277-1941
Practice Address - Street 1:1007 CHERAW ST
Practice Address - Street 2:
Practice Address - City:BENNETTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29512-2422
Practice Address - Country:US
Practice Address - Phone:843-523-6319
Practice Address - Fax:843-523-6320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-29
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCHPC-0069251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1245214980OtherNPI
SCHSP046Medicaid
NC3401555Medicaid
SCHSP046Medicaid
NC3401555Medicaid