Healthcare Provider Details

I. General information

NPI: 1982882114
Provider Name (Legal Business Name): SERENITY HOSPICE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 07/13/2023
Certification Date: 07/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 TALLULAH TRL STE 202
WARNER ROBINS GA
31088-7697
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 478-929-1616
  • Fax: 478-929-1664
Mailing address:
  • Phone: 800-932-2738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number076-037-H
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number087-0246-H
License Number StateGA

VIII. Authorized Official

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