SOUTHERNCARE INC. NPI 1952348435

NPI Information

NPI: 1952348435
Provider Name: SOUTHERNCARE, INC.

Doing Business As: SOUTHERNCARE MOULTRIE

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization
Address:
143 SOUTH HIGHWAY 319
SUITE 1
MOULTRIE, GA
ZIP 31768
Phone: (229) 217-0523
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SOUTHERNCARE, INC. is a hospice care community based in Moultrie, GA. SOUTHERNCARE, INC. NPI is 1952348435. The provider is registered as an organization entity type.
The provider Is Doing Business As Southerncare Moultrie.

The provider's business location address is:

143 SOUTH HIGHWAY 319
SUITE 1
MOULTRIE, GA
ZIP 31768-733
Phone: (229) 217-0523
Fax: (229) 217-4974

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 6/1/2006 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		035204H	GEORGIA	No
2	251G00000X	Hospice Care, Community Based		035-204-H	GEORGIA	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	433936856B	MEDICAID	GEORGIA
2	111611	MEDICARE OSCAR/CERTIFICATION
3	11-1611	MEDICARE PIN	GEORGIA

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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