Healthcare Provider Details

I. General information

NPI: 1780849026
Provider Name (Legal Business Name): WIREGRASS HOSPICE OF SOUTH CAROLINA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2008
Last Update Date: 04/07/2026
Certification Date: 01/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4975 LACROSS RD STE 200A
NORTH CHARLESTON SC
29406-6531
US

IV. Provider business mailing address

655 BRAWLEY SCHOOL RD STE 200
MOORESVILLE NC
28117-9601
US

V. Phone/Fax

Practice location:
  • Phone: 843-529-3100
  • Fax:
Mailing address:
  • Phone: 704-664-2876
  • Fax: 704-664-1306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

Name: MS. JANET COMBS
Title or Position: VP OF LICENSURE
Credential:
Phone: 704-664-2876