Healthcare Provider Details

I. General information

NPI: 1548398720
Provider Name (Legal Business Name): HOSPICE & PALLIATIVE CARE CHARLOTTE REGION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7845 LITTLE AVE
CHARLOTTE NC
28226-8198
US

IV. Provider business mailing address

PO BOX 470408
CHARLOTTE NC
28247-0408
US

V. Phone/Fax

Practice location:
  • Phone: 704-375-0100
  • Fax:
Mailing address:
  • Phone: 704-375-0100
  • Fax: 704-887-6450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberHC0369
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. PETER ALLEN BRUNNICK
Title or Position: CHIEF FINANCIAL OFFICER
Credential: CPA
Phone: 704-375-0100