Organization Active NPI

Interim Health Care Hospice LLC

  • Community Based Hospice Care Agency
  • Greenville, SC
National Provider Identifier
1942250642
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
HPC0213 Issued in SC
Legal business name
INTERIM HEALTH CARE HOSPICE LLC
Practice address
16 Hyland Rd
Greenville, SC 29615-5756
Phone
(864) 627-1200
Fax
(864) 627-7102
NPI assigned
May 11, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
INTERIM HEALTHCARE OF GREENVILLE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Raymond Reilly Schroeder
Title
President
Phone
(864) 627-1200

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X HPC-045 SC
Community Based Hospice Care Agency 251G00000X HPC0213 SC Primary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X SC

Addresses

Primary practice location

16 Hyland Rd
Greenville, SC 29615-5756

Mailing address

16 Hyland Rd
Greenville, SC 29615-5756
Phone (864) 627-1200

Other identifiers 1

IdentifierTypeStateIssuer
HSP033MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory

Locations

101 S John St
Ste M
Blacksburg, SC 29702
Phone (864) 839-1310

775 Spartan Blvd
Ste 101
Spartanburg, SC 29301
Phone (864) 587-5115

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Jan 1, 2018 Change of OwnershipThis provider was the seller Interim Healthcare of the UpstateCCN 421533, SC, NPI 1538638994

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1942250642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 HYLAND RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296155756",
            "telephone_number": "864-627-1200",
            "fax_number": "864-627-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 HYLAND RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296155756",
            "telephone_number": "864-627-1200",
            "fax_number": "864-627-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERIM HEALTH CARE HOSPICE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTERIM HEALTHCARE OF GREENVILLE, INC.",
        "enumeration_date": "2006-05-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SCHROEDER",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "REILLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-627-1200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "SC",
            "license": "HPC-045",
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "SC",
            "license": "HPC0213",
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "SC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP033",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.