Basic Information
| Provider Information | |||||||||
| NPI: | 1407140387 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CRESCENT HOSPICE, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 FAULCONER DRIVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | CHARLOTTESVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 22903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4349779711 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1370 BROWNING RD STE 120 | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037323274 | ||||||||
| FaxNumber: | 8037324294 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2011 | ||||||||
| LastUpdateDate: | 01/09/2020 | ||||||||
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| AuthorizedOfficialLastName: | HUNTER | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | B. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT & CEO | ||||||||
| AuthorizedOfficialTelephone: | 4349779711 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 01/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251G00000X | HPC-0160 | SC | Y | Agencies | Hospice Care, Community Based |
No ID Information.