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Organization

HOSPICE & PALLIATIVE CARECENTER

Active
Other names
Trellis Supportive Care
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID SHELTON (CFO)
(336) 331-1260
Entity
Organization

Contact information

Practice address
101 HOSPICE LN, BLDG 141, WINSTON SALEM, NC 27103-5766
(336) 768-3972
(336) 659-0461
Mailing address
101 HOSPICE LANE BLDG 141, HOSPICE AND PALLIATIVE CARE CENTER, WINSTON SALEM, NC 27103-5766
(336) 768-3972
(336) 659-0461

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0023A
BCBS HOSPICE
NC
01
00735
BCBS HOMEHEALTH
NC
01
15115
MEDCOST
NC
Enumeration date
02/05/2008
Last updated
09/27/2018
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