Provider Demographics
NPI:1538298781
Name:HOSPICE AND PALLIATIVE CARE OF THE PIEDMONT INC
Entity Type:Organization
Organization Name:HOSPICE AND PALLIATIVE CARE OF THE PIEDMONT INC
Other - Org Name:HOMECARE OF HOSPICECARE OF THE PIEDMONT INC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:L
Authorized Official - Last Name:KISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-227-9393
Mailing Address - Street 1:408 W ALEXANDER AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-4031
Mailing Address - Country:US
Mailing Address - Phone:864-227-9393
Mailing Address - Fax:864-227-9377
Practice Address - Street 1:408 W ALEXANDER AVE
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-4031
Practice Address - Country:US
Practice Address - Phone:864-227-9393
Practice Address - Fax:864-227-9377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208D00000X
SCHPC10251G00000X, 315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No251G00000XAgenciesHospice Care, Community Based
No315D00000XNursing & Custodial Care FacilitiesHospice, InpatientGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP4403Medicaid
SCGP4403Medicaid