VISTACARE USA INC. NPI 1417902719

NPI Information

NPI: 1417902719
Provider Name: VISTACARE USA, INC.

Doing Business As: VISTACARE

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization
Address:
1000 TOWNE CENTER BLVD
SUITE 604
POOLER, GA
ZIP 31322
Phone: (912) 330-0460
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VISTACARE USA, INC. is a hospice care community based in Pooler, GA. VISTACARE USA, INC. NPI is 1417902719. The provider is registered as an organization entity type.
The provider Is Doing Business As Vistacare.

The provider's business location address is:

1000 TOWNE CENTER BLVD
SUITE 604
POOLER, GA
ZIP 31322-052
Phone: (912) 330-0460
Fax: (912) 330-0409

The provider's authorized official is Rodney Dirk Allison .
The authorized official title is Sr Vp & Cfo and has the following contact phone number (214) 922-9711.

The enumeration date for this NPI number is 5/24/2006 and was last updated on 3/10/2008.

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		025-114-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	Other Provider Identifier Issuer
1	00821312A	MEDICAID	GEORGIA
2	111555	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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