# PRUITTHEALTH HOSPICE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PruittHealth Hospice - Fayetteville
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386036473
- **Authorized official:** MR. NEIL L. PRUITT JR. (CHAIRMAN AND CEO)
- **Authorized official phone:** (770) 279-6200

## Contact information

- **Practice address:** 2850 VILLAGE DR STE 102, FAYETTEVILLE, NC 28304-3864
- **Practice address phone:** (910) 483-1793
- **Practice address fax:** (910) 483-4315
- **Mailing address:** 1626 JEURGENS CT, NORCROSS, GA 30093-2219
- **Mailing address phone:** (770) 279-6200
- **Mailing address fax:** (770) 931-5278

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 315D00000X | Inpatient Hospice | — | NULL | Yes |

## Other

- **Enumeration date:** 02/26/2015
- **Last updated:** 12/21/2020