Healthcare Provider Details

I. General information

NPI: 1689000986
Provider Name (Legal Business Name): HOSPICE ADVANTAGE, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2013
Last Update Date: 12/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 BLARNEY DR SUITE 202A
COLUMBIA SC
29223-6291
US

IV. Provider business mailing address

401 CENTER AVE
BAY CITY MI
48708-5939
US

V. Phone/Fax

Practice location:
  • Phone: 803-699-3233
  • Fax: 803-699-3919
Mailing address:
  • Phone: 989-891-2210
  • Fax: 989-893-5268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberHPC142
License Number StateSC

VIII. Authorized Official

Name: RODNEY HILDEBRANT
Title or Position: PRESIDENT
Credential:
Phone: 989-891-2210