Provider Demographics
NPI:1992446397
Name:AFFINITY PALLIATIVE SOUTH CAROLINA LLC
Entity type:Organization
Organization Name:AFFINITY PALLIATIVE SOUTH CAROLINA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:CANTRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-949-0400
Mailing Address - Street 1:135 GEMINI CIR STE 202
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-5842
Mailing Address - Country:US
Mailing Address - Phone:205-949-0400
Mailing Address - Fax:205-949-0405
Practice Address - Street 1:3441 PELHAM RD STE 101
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4184
Practice Address - Country:US
Practice Address - Phone:864-482-7110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-07
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty