Provider Demographics
NPI:1710994397
Name:SANTEE HOSPICE LLC
Entity Type:Organization
Organization Name:SANTEE HOSPICE LLC
Other - Org Name:ADVANTAGE HOSPICE AND HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:TUCKER
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:910-273-5550
Mailing Address - Street 1:405 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-5556
Mailing Address - Country:US
Mailing Address - Phone:910-345-0030
Mailing Address - Fax:910-345-0041
Practice Address - Street 1:259 BROAD ST
Practice Address - Street 2:SUITE A
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4146
Practice Address - Country:US
Practice Address - Phone:803-774-8400
Practice Address - Fax:803-774-8401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCHPC160251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCHSP-078Medicaid
SC=========OtherHUMANA
SCHSP-078Medicaid