Provider Demographics
NPI:1154757474
Name:HADORA HOSPICE OF THE CAROLINAS
Entity type:Organization
Organization Name:HADORA HOSPICE OF THE CAROLINAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-667-9012
Mailing Address - Street 1:PO BOX 1671
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-1671
Mailing Address - Country:US
Mailing Address - Phone:803-667-9012
Mailing Address - Fax:803-807-9377
Practice Address - Street 1:6156 SAINT ANDREWS RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-3147
Practice Address - Country:US
Practice Address - Phone:803-667-9012
Practice Address - Fax:803-807-9377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-18
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20134688945919315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient