Provider Demographics
NPI:1174956098
Name:HOSPICE CARE OF SOUTH CAROLINA, LLC
Entity type:Organization
Organization Name:HOSPICE CARE OF SOUTH CAROLINA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNCAN OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-932-2738
Mailing Address - Street 1:187 N CHURCH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29306-5154
Mailing Address - Country:US
Mailing Address - Phone:800-932-2738
Mailing Address - Fax:
Practice Address - Street 1:136 STONEMARK LN STE 100C
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-3881
Practice Address - Country:US
Practice Address - Phone:800-932-2738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOSPICE CARE OF SOUTH CAROLINA, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-14
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207PH0002X, 207RH0002X, 2080H0002X, 207QH0002X
SCHPC-0051251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No207PH0002XAllopathic & Osteopathic PhysiciansEmergency MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No2080H0002XAllopathic & Osteopathic PhysiciansPediatricsHospice and Palliative MedicineGroup - Multi-Specialty
No251G00000XAgenciesHospice Care, Community BasedGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP6241Medicaid