Tidewater Hospice Augusta LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1210432H Issued in GA

Legal business name

TIDEWATER HOSPICE AUGUSTA LLC

Practice address

206 Pitcarin Way
Suite B
Augusta, GA 30909-5766

Phone

(803) 600-0842

NPI assigned

Sep 14, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Stephanie Guest, RPH

Title

Cfo

Phone

(803) 600-0842

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473811200000",
    "number": "1669920005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 PLEASANT POINT DRIVE",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "29907",
            "telephone_number": "803-600-0842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 PITCARIN WAY",
            "address_2": "SUITE B",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309095766",
            "telephone_number": "803-600-0842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDEWATER HOSPICE AUGUSTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-14",
        "last_updated": "2016-09-14",
        "status": "A",
        "authorized_official_last_name": "GUEST",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "803-600-0842",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "1210432H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Todd Elliott Thurston, M.D.
• Licheng Tian, MD/PHD
• Sijia Tian
• Gabrielle Marie Tibbetts
• Julie Elise Tibbetts, LPC
• Lillie Tien, MD
• Lauren W Tiernan, APRN
• Mary Christina Tillman, PA-C
• Sherri Anita Tillman, MCD, CCC-SLP
• Clayton Douglas Timmerman, DMD

• Home Health Agency in Augusta, GA
• Providers in Augusta, GA by specialty
• Home Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.