SOUTHERNCARE INC. NPI 1154368496

NPI Information

NPI: 1154368496
Provider Name: SOUTHERNCARE, INC.

Doing Business As: SOUTHERNCARE WACO

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization
Address:
8005 BAGBY AVENUE
HEWITT, TX
ZIP 76643
Phone: (254) 420-2773
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SOUTHERNCARE, INC. is a hospice care community based in Hewitt, TX. SOUTHERNCARE, INC. NPI is 1154368496. The provider is registered as an organization entity type.
The provider Is Doing Business As Southerncare Waco.

The provider's business location address is:

8005 BAGBY AVENUE
HEWITT, TX
ZIP 76643-576
Phone: (254) 420-2773
Fax: (254) 420-2876

The provider's authorized official is Jessica Kleberg .
The authorized official title is Vp Of Legal Affairs and has the following contact phone number (704) 664-2876.

The enumeration date for this NPI number is 6/2/2006 and was last updated on 5/16/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251G00000X	Hospice Care, Community Based		014934	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	45-1759	MEDICARE PIN	TEXAS
2	001012670	MEDICAID	TEXAS
3	451759	MEDICARE OSCAR/CERTIFICATION

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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