MEDICARE: HOSPICE OF THE CAROLINA FOOTHILLS, 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	HPC-035	SC
2	251G00000X	Community Based Hospice Care Agency	HOS0396	NC

General Provider Information

NPI Number	:	1801895313
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPICE OF THE CAROLINA FOOTHILLS, INC

Provider Business Mailing Address
First Line	:	130 FOREST GLEN RD
Second Line	:
City	:	COLUMBUS
State	:	NC
Zip	:	28722-3456
Country	:	US
Telephone Number	:	828-894-7000
Fax Number	:	828-894-2254

Provider Business Practice Location Address
First Line	:	130 FOREST GLEN RD
Second Line	:
City	:	COLUMBUS
State	:	NC
Zip	:	28722-3456
Country	:	US
Telephone Number	:	828-894-7000
Fax Number	:	828-894-2254

Authorized Official
Title or Position	:	CLINICAL OFFICE MANAGER
Name	:	CHRISTY R. FISHER
Credential	:
Telephone Number	:	828-894-7000

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	08/12/2015

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