Provider Demographics
NPI:1952467417
Name:HOSPICECARE OF THE PIEDMONT, INC.
Entity Type:Organization
Organization Name:HOSPICECARE OF THE PIEDMONT, INC.
Other - Org Name:HOMECARE OF HOSPICECARE OF THE PIEDMONT, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:B
Authorized Official - Last Name:CORLEY
Authorized Official - Suffix:
Authorized Official - Credentials:BS,RN
Authorized Official - Phone:864-227-9393
Mailing Address - Street 1:408 W ALEXANDER AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-4031
Mailing Address - Country:US
Mailing Address - Phone:864-227-9393
Mailing Address - Fax:864-227-9377
Practice Address - Street 1:408 W ALEXANDER AVE
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-4031
Practice Address - Country:US
Practice Address - Phone:864-227-9393
Practice Address - Fax:864-227-9377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCHHA134251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC471118Medicaid
SC=========001OtherBCBS OF SC PROVIDER #
SC471118Medicaid