Provider Demographics
NPI:1801418942
Name:CAROLINA COMMUNITY CARE, INC.
Entity Type:Organization
Organization Name:CAROLINA COMMUNITY CARE, INC.
Other - Org Name:HOSPICE & COMMUNITY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-329-1500
Mailing Address - Street 1:PO BOX 993
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29731-6993
Mailing Address - Country:US
Mailing Address - Phone:803-329-1500
Mailing Address - Fax:803-329-9697
Practice Address - Street 1:2275 INDIA HOOK RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1223
Practice Address - Country:US
Practice Address - Phone:803-329-1500
Practice Address - Fax:803-329-9697
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAROLINA COMMUNITY CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-12
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No251G00000XAgenciesHospice Care, Community BasedGroup - Multi-Specialty