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General NPI Number Information
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NPI Number | 1962351338
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Entity Type | Organization
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Legal Business Name | LIFECARE SUPPORTIVE MEDICINE INCORPORATED
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Dates
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Enumeration Date | 01/27/2026
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 1314 3RD AVE
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City | CONWAY
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State | SC
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Zip | 29526-5002
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Country | US
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Telephone | 910-796-7900
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Fax | 910-796-7901
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Provider Business Mailing Address
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Address Line | 1414 PHYSICIANS DR
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City | WILMINGTON
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State | NC
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Zip | 28401-7335
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Country | US
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Telephone | 910-796-7988
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Fax | 910-341-1908
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Authorized Official
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Title or Position | VP OF FINANCE
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Name | JASON PISANI
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Credential |
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Telephone | 910-796-7952
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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