Healthcare Provider Details

I. General information

NPI: 1144545484
Provider Name (Legal Business Name): COMPASSIONATE CARE HOSPICE OF SOUTH CAROLINA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2010
Last Update Date: 10/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 SAINT ANDREWS RD BUILDING D SUITE 1
COLUMBIA SC
29210-4486
US

IV. Provider business mailing address

3854 AMERICAN WAY STE A
BATON ROUGE LA
70816-4897
US

V. Phone/Fax

Practice location:
  • Phone: 843-448-7107
  • Fax: 843-448-7390
Mailing address:
  • Phone: 225-292-2031
  • Fax: 225-295-9678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA U. GOFF
Title or Position: DELEGATED OFFICIAL
Credential:
Phone: 225-299-3701