Healthcare Provider Details

I. General information

NPI: 1902476500
Provider Name (Legal Business Name): HOSPICE CARE OF GEORGIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2743 PERIMETER PKWY STE 230B
AUGUSTA GA
30909-4576
US

IV. Provider business mailing address

187 N CHURCH ST STE 201
SPARTANBURG SC
29306-5154
US

V. Phone/Fax

Practice location:
  • Phone: 800-932-2738
  • Fax:
Mailing address:
  • Phone: 800-932-2738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080H0002X
TaxonomyPediatric Hospice and Palliative Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207PH0002X
TaxonomyHospice and Palliative Medicine (Emergency Medicine) Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: PAMELA DUNCAN OWENS
Title or Position: CHIEF COMPLIANCE OFFICER
Credential:
Phone: 800-932-2738