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General NPI Number Information
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NPI Number | 1548398720
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Entity Type | Organization
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Legal Business Name | HOSPICE & PALLIATIVE CARE CHARLOTTE REGION
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 7845 LITTLE AVE
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City | CHARLOTTE
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State | NC
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Zip | 28226-8198
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Country | US
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Telephone | 704-375-0100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 470408
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City | CHARLOTTE
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State | NC
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Zip | 28247-0408
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Country | US
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Telephone | 704-375-0100
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Fax | 704-887-6450
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. PETER ALLEN BRUNNICK
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Credential | CPA
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Telephone | 704-375-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | HC0369
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License Number State | NC
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