# TIDEWATER HOSPICE AUGUSTA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669920005
- **Authorized official:** STEPHANIE GUEST RPH (CFO)
- **Authorized official phone:** (803) 600-0842

## Contact information

- **Practice address:** 206 PITCARIN WAY, SUITE B, AUGUSTA, GA 30909-5766
- **Practice address phone:** (803) 600-0842
- **Mailing address:** 335 PLEASANT POINT DRIVE, BEAUFORT, SC 29907
- **Mailing address phone:** (803) 600-0842

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 1210432H | GA | Yes |

## Other

- **Enumeration date:** 09/14/2016
- **Last updated:** 09/14/2016