Healthcare Provider Details

I. General information

NPI: 1578854147
Provider Name (Legal Business Name): HOSPICE OF SURRY COUNTY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2011
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 N CRUTCHFIELD ST UNIT 2
DOBSON NC
27017-8804
US

IV. Provider business mailing address

PO BOX 325
DOBSON NC
27017-0325
US

V. Phone/Fax

Practice location:
  • Phone: 336-789-2922
  • Fax: 336-789-0856
Mailing address:
  • Phone: 336-789-2922
  • Fax: 336-789-0856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. TRACEY SMITH DOBSON
Title or Position: INTERIM CEO
Credential: RN, BSN
Phone: 336-789-2922