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NPI Code Detail

MEDICARE: CRESCENT HOSPICE, INC.

MEDICARE: CRESCENT HOSPICE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251G00000XCommunity Based Hospice Care Agency

General Provider Information

NPI Number : 1407140387
Entity Type Code : Organization
Provider Name (Legal Business Name) : CRESCENT HOSPICE, INC.
Provider Business Mailing Address
First Line : 500 FAULCONER DR STE 200
Second Line :
City : CHARLOTTESVILLE
State : VA
Zip : 22903-5089
Country : US
Telephone Number : 434-977-9711
Fax Number : 434-235-4142
Provider Business Practice Location Address
First Line : 1370 BROWNING RD STE 110
Second Line :
City : COLUMBIA
State : SC
Zip : 29210-6939
Country : US
Telephone Number : 803-732-3274
Fax Number : 803-732-4294
Authorized Official
Title or Position : CHIEF ADMINISTRATIVE OFFICER
Name : JESSE R MOORE
Credential :
Telephone Number : 857-331-6271
Provider Enumeration Date : 06/08/2011
Last Update Date : 05/12/2025

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