1649279050 NPI number — HOPE HOSPICE, LLC

Table of content: (NPI 1649279050)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649279050 NPI number — HOPE HOSPICE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOPE HOSPICE, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ACG HOSPICE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649279050
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/01/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
187 N CHURCH ST STE 201
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPARTANBURG
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29306-5154
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-932-2738
Provider Business Mailing Address Fax Number:
888-847-9306

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
651 MAIN ST STE 159
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GARDENDALE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35071-2793
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-583-4673
Provider Business Practice Location Address Fax Number:
205-316-2833
Provider Enumeration Date:
07/18/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DUNCAN
Authorized Official First Name:
PAMELA
Authorized Official Middle Name:
Authorized Official Title or Position:
CCO
Authorized Official Telephone Number:
800-932-2738

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  10231 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 012-433 . This is a "BLUECROSS BLUESHIELD" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: PIC1591E , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".