Provider Demographics
NPI:1447497961
Name:HOSPICE OF THE CAROLINA FOOTHILLS, INC
Entity type:Organization
Organization Name:HOSPICE OF THE CAROLINA FOOTHILLS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:ECKERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-894-7000
Mailing Address - Street 1:PO BOX 127
Mailing Address - Street 2:
Mailing Address - City:LANDRUM
Mailing Address - State:SC
Mailing Address - Zip Code:29356-0127
Mailing Address - Country:US
Mailing Address - Phone:864-457-9100
Mailing Address - Fax:864-457-9120
Practice Address - Street 1:260 FAIRWINDS RD.
Practice Address - Street 2:
Practice Address - City:LANDRUM
Practice Address - State:SC
Practice Address - Zip Code:29356-9075
Practice Address - Country:US
Practice Address - Phone:864-457-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOSPICE OF THE CAROLINA FOOTHILLS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-21
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCHPF0015315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC421587Medicare PIN