MEDICARE: COMMUNITY HOSPICE, LLC

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	HOS2302/HC3439	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891736336
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HOSPICE, LLC

Provider Business Mailing Address
First Line	:	655 BRAWLEY SCHOOL RD
Second Line	:	SUITE 200
City	:	MOORESVILLE
State	:	NC
Zip	:	28117-9125
Country	:	US
Telephone Number	:	704-664-2876
Fax Number	:	704-664-1306

Provider Business Practice Location Address
First Line	:	1423 S GLENBURNIE RD
Second Line	:	SUITE A
City	:	NEW BERN
State	:	NC
Zip	:	28562-2603
Country	:	US
Telephone Number	:	252-672-8301
Fax Number	:	855-250-9588

Authorized Official
Title or Position	:	VP, LICENSURE
Name	:	JANET COMBS
Credential	:
Telephone Number	:	913-814-2013

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	03/24/2022

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Directions to “COMMUNITY HOSPICE, LLC ” Practice Location

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