Provider Demographics
NPI:1578565818
Name:HOT SPRINGS HEALTH PROGRAM, INC.
Entity Type:Organization
Organization Name:HOT SPRINGS HEALTH PROGRAM, INC.
Other - Org Name:HOSPICE OF MADISON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:B
Authorized Official - Last Name:STROM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-649-9566
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:NC
Mailing Address - Zip Code:28753-0069
Mailing Address - Country:US
Mailing Address - Phone:828-649-9566
Mailing Address - Fax:828-649-0687
Practice Address - Street 1:590 MEDICAL PARK DR.
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:NC
Practice Address - Zip Code:28753
Practice Address - Country:US
Practice Address - Phone:828-649-9566
Practice Address - Fax:828-649-0687
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOT SPRINGS HEALTH PROGRAM, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-01
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC0419251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0022POtherBCBS NC HOS PROVIDER NO.
NC3401540Medicaid
NC0022POtherBCBS NC HOS PROVIDER NO.
NC=========OtherCIGNA HOS PROVIDER NO.