MEDICARE: HOT SPRINGS HEALTH PROGRAM, 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	HC0419	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0022P	OTHER	NC	BCBS NC HOS PROVIDER NO.
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578565818
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOT SPRINGS HEALTH PROGRAM, INC.

Provider Business Mailing Address
First Line	:	PO BOX 69
Second Line	:
City	:	MARSHALL
State	:	NC
Zip	:	28753-0069
Country	:	US
Telephone Number	:	828-649-9566
Fax Number	:	828-649-0687

Provider Business Practice Location Address
First Line	:	590 MEDICAL PARK DR.
Second Line	:
City	:	MARSHALL
State	:	NC
Zip	:	28753
Country	:	US
Telephone Number	:	828-649-9566
Fax Number	:	828-649-0687

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	TERESA B STROM
Credential	:
Telephone Number	:	828-649-9566

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	07/28/2016

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Directions to “HOT SPRINGS HEALTH PROGRAM, INC. ” Practice Location

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