Provider Demographics
NPI:1548697907
Name:AGAPE COMMUNITY HOSPICE OF THE PIEDMONT INC
Entity type:Organization
Organization Name:AGAPE COMMUNITY HOSPICE OF THE PIEDMONT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:803-329-4544
Mailing Address - Street 1:1380 EBENEZER RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-3391
Mailing Address - Country:US
Mailing Address - Phone:803-366-3598
Mailing Address - Fax:
Practice Address - Street 1:1380 EBENEZER RD
Practice Address - Street 2:SUITE A
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-3391
Practice Address - Country:US
Practice Address - Phone:803-366-3598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-01
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCHPC-0172Medicaid