Provider Demographics
NPI:1760458657
Name:HOSPICE OF YANCEY COUNTY, INC.
Entity Type:Organization
Organization Name:HOSPICE OF YANCEY COUNTY, INC.
Other - Org Name:COMPASSIONATE CARE WESTERN NORTH CAROLINA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:GREGORY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-682-9675
Mailing Address - Street 1:856 GEORGES FORK RD
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28714-7842
Mailing Address - Country:US
Mailing Address - Phone:828-682-9675
Mailing Address - Fax:828-682-4713
Practice Address - Street 1:856 GEORGES FORK RD
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28714-7842
Practice Address - Country:US
Practice Address - Phone:828-682-9675
Practice Address - Fax:828-682-4713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-28
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207QH0002X
NCHOS1027251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community BasedGroup - Multi-Specialty
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3401564Medicaid
NC341564Medicare Oscar/Certification