Provider Demographics
NPI:1912912890
Name:HOSPICE OF LAURENS COUNTY INC
Entity type:Organization
Organization Name:HOSPICE OF LAURENS COUNTY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRUNNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-375-0100
Mailing Address - Street 1:1304 SPRINGDALE DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:SC
Mailing Address - Zip Code:29325-7226
Mailing Address - Country:US
Mailing Address - Phone:864-833-6287
Mailing Address - Fax:864-833-0556
Practice Address - Street 1:1304 SPRINGDALE DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:SC
Practice Address - Zip Code:29325
Practice Address - Country:US
Practice Address - Phone:864-833-6287
Practice Address - Fax:864-833-0556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207QH0002X
SCHPC025251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community BasedGroup - Single Specialty
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCHSP014Medicaid
SC421520Medicare ID - Type Unspecified