Provider Demographics
NPI:1801895313
Name:HOSPICE OF THE CAROLINA FOOTHILLS, INC
Entity type:Organization
Organization Name:HOSPICE OF THE CAROLINA FOOTHILLS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:R
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-894-7000
Mailing Address - Street 1:130 FOREST GLEN RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NC
Mailing Address - Zip Code:28722-3456
Mailing Address - Country:US
Mailing Address - Phone:828-894-7000
Mailing Address - Fax:828-894-2254
Practice Address - Street 1:130 FOREST GLEN RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NC
Practice Address - Zip Code:28722-3456
Practice Address - Country:US
Practice Address - Phone:828-894-7000
Practice Address - Fax:828-894-2254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-18
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCHPC-035251G00000X
NCHOS0396251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC341557Medicare Oscar/Certification