Provider Demographics
NPI:1518672658
Name:1ST CARE HOSPICE INC
Entity Type:Organization
Organization Name:1ST CARE HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BURKHOLDER
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:434-572-1582
Mailing Address - Street 1:PO BOX 1006
Mailing Address - Street 2:
Mailing Address - City:SOUTH BOSTON
Mailing Address - State:VA
Mailing Address - Zip Code:24592-1006
Mailing Address - Country:US
Mailing Address - Phone:434-572-1582
Mailing Address - Fax:434-572-2631
Practice Address - Street 1:425 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTH BOSTON
Practice Address - State:VA
Practice Address - Zip Code:24592-3241
Practice Address - Country:US
Practice Address - Phone:434-572-0063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAHSP-23453Medicaid