MEDICARE: HOSPICE CARE OF THE CAROLINAS, 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
1	251G00000X	Community Based Hospice Care Agency
2	251G00000X	Community Based Hospice Care Agency		SC

General Provider Information

NPI Number	:	1508179573
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPICE CARE OF THE CAROLINAS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 37105
Second Line	:	2238 EBENEZER DRIVE
City	:	ROCK HILL
State	:	SC
Zip	:	29732-0535
Country	:	US
Telephone Number	:	803-242-4660
Fax Number	:	803-328-2812

Provider Business Practice Location Address
First Line	:	2238 EBENEZER RD
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-9288
Country	:	US
Telephone Number	:	803-242-4660
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MR. MICHAEL C. ROCKHOLT
Credential	:
Telephone Number	:	803-242-4660

Provider Enumeration Date	:	07/20/2010
Last Update Date	:	07/20/2010

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