1396949905 NPI number — AGAPE COMMUNITY HOSPICE OF ANDERSON, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396949905 NPI number — AGAPE COMMUNITY HOSPICE OF ANDERSON, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AGAPE COMMUNITY HOSPICE OF ANDERSON, INC.
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:
Provider Other Organization Name Type Code:
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:
1396949905
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/24/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300B E GREENVILLE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANDERSON
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29621-5534
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-332-1500
Provider Business Mailing Address Fax Number:
864-332-1575

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300B E GREENVILLE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANDERSON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29621-5534
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-332-1500
Provider Business Practice Location Address Fax Number:
864-332-1575
Provider Enumeration Date:
06/14/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HAM
Authorized Official First Name:
DEBRA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
864-332-1500

Provider Taxonomy Codes

  • Taxonomy code: 302R00000X , with the licence number:  HPC-118 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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