Affinity Palliative South Carolina LLC
Organization Active NPI Hospice and Palliative Medicine (Internal Medicine) Physician · Greenville, SC
NPI 1992446397 · NPPES record last updated Mar 11, 2024
Key facts
- NPI
- 1992446397
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X
- Legal business name
- AFFINITY PALLIATIVE SOUTH CAROLINA LLC
- Practice address
- 3441 Pelham Rd Ste 101
Greenville, SC 29615-4184 - Phone
- (864) 482-7110
- NPI assigned
- Apr 7, 2022
- Organization subpart
- No
Authorized official
- Name
- Rick Cantrell
- Title
- Ceo
- Phone
- (205) 949-0400
Practitioners 1
-
Jeanine Bowen, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230331000384 | SC | Part B Supplier - Clinic/Group Practice | 0547635765 |
Receives reassigned benefits from 1 practitioner Practice locations: Greenville, SC |
National Provider Directory
Locations
606 Oak Mountain Commons Ln
Pelham, AL 35124
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospice and Palliative Medicine (Internal Medicine) Physician |
207RH0002X | Yes |
Addresses
Primary practice location
3441 Pelham Rd Ste 101
Greenville, SC 29615-4184
Mailing address
135 Gemini Cir Ste 202
Birmingham, AL 35209-5842
Phone (205) 949-0400
Other names
- Affinity Palliative Care
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.