Healthcare Provider Details

I. General information

NPI: 1346265329
Provider Name (Legal Business Name): PINEVIEW HOSPICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 SMITH AVE.
LIVINGSTON AL
35470-0176
US

IV. Provider business mailing address

PO BOX 176
LIVINGSTON AL
35470-0176
US

V. Phone/Fax

Practice location:
  • Phone: 205-652-4365
  • Fax: 205-652-6624
Mailing address:
  • Phone: 205-652-4365
  • Fax: 205-652-6624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number11743
License Number StateAL

VIII. Authorized Official

Name: MS. KAY S STEPHENS
Title or Position: OWNER DIRECTOR
Credential:
Phone: 205-652-4365