1275524621 NPI number — HOSPICE OF HENDERSON COUNTY, INC.

Table of content: STEPHANIE SCIARRA SMITH P.T. (NPI 1194741900)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275524621 NPI number — HOSPICE OF HENDERSON COUNTY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOSPICE OF HENDERSON COUNTY, 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:
6
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:
1275524621
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/28/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
571 S ALLEN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLAT ROCK
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28731-9447
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-692-6178
Provider Business Mailing Address Fax Number:
828-233-0355

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
571 S ALLEN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLAT ROCK
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28731-9447
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-692-6178
Provider Business Practice Location Address Fax Number:
828-233-0350
Provider Enumeration Date:
11/03/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BURKE-SINCLAIR
Authorized Official First Name:
MILLICENT
Authorized Official Middle Name:
GRACE
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
828-692-6178

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  HOS0386 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 5911482 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2328856 . This is a "MEDICARE GROUP #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3401530 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 022J . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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