Provider Demographics
NPI: | 1750478350 |
---|---|
Name: | COMMUNITY CAREPARTNERS, INC. |
Entity Type: | Organization |
Organization Name: | COMMUNITY CAREPARTNERS, INC. |
Other - Org Name: | CAREPARTNERS HOSPICE & PALLIATIVE CARE SERVICES |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | TRACY |
Authorized Official - Middle Name: | T |
Authorized Official - Last Name: | BUCHANAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 828-277-4800 |
Mailing Address - Street 1: | 68 SWEETEN CREEK ROAD |
Mailing Address - Street 2: | |
Mailing Address - City: | ASHEVILLE |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 28803-2318 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 828-277-4800 |
Mailing Address - Fax: | 828-277-4865 |
Practice Address - Street 1: | 68 SWEETEN CREEK ROAD |
Practice Address - Street 2: | |
Practice Address - City: | ASHEVILLE |
Practice Address - State: | NC |
Practice Address - Zip Code: | 28803-2318 |
Practice Address - Country: | US |
Practice Address - Phone: | 828-277-4800 |
Practice Address - Fax: | 828-277-4865 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | COMMUNITY CAREPARTNERS, INC. |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2006-10-06 |
Last Update Date: | 2012-05-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
207Q00000X, 207QH0002X, 207R00000X, 207RH0002X, 208000000X, 2080P0203X, 363L00000X, 363LA2200X, 363LF0000X, 363LG0600X | ||
NC | HOS0113 | 251G00000X, 315D00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 315D00000X | Nursing & Custodial Care Facilities | Hospice, Inpatient | Group - Multi-Specialty | |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 207QH0002X | Allopathic & Osteopathic Physicians | Family Medicine | Hospice and Palliative Medicine | Group - Multi-Specialty |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207RH0002X | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine | Group - Multi-Specialty |
No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
No | 2080P0203X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Critical Care Medicine | Group - Multi-Specialty |
No | 251G00000X | Agencies | Hospice Care, Community Based | Group - Multi-Specialty | |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty | |
No | 363LA2200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | Group - Multi-Specialty |
No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Multi-Specialty |
No | 363LG0600X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NY | 72-71715 | Other | UNITED HEALTH CARE PROV # |
NC | 3411501 | Medicaid | |
NC | 0021K | Other | BCBS PROVIDER NUMBER |
341501 | Medicare Oscar/Certification | ||
2345549 | Medicare PIN |