Provider Demographics
NPI:1780419523
Name:CAROMONT SERIOUS ILLNESS PARTNERS, LLC
Entity type:Organization
Organization Name:CAROMONT SERIOUS ILLNESS PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-466-0466
Mailing Address - Street 1:3975 ROBINSON RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NC
Mailing Address - Zip Code:28658-9715
Mailing Address - Country:US
Mailing Address - Phone:828-466-0466
Mailing Address - Fax:828-466-8862
Practice Address - Street 1:2240 REMOUNT RD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-4725
Practice Address - Country:US
Practice Address - Phone:704-861-8405
Practice Address - Fax:704-865-0590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-03
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based