Healthcare Provider Details
I. General information
NPI: 1558309930
Provider Name (Legal Business Name): SOUTHERNCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/04/2006
Last Update Date: 04/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3100 COTTAGE HILL RD STE 112 & 117
MOBILE AL
36606-2913
US
IV. Provider business mailing address
2204 LAKESHORE DR SUITE 475
BIRMINGHAM AL
35209-6705
US
V. Phone/Fax
- Phone: 251-479-4494
- Fax: 251-479-8166
- Phone: 205-868-4400
- Fax: 205-868-4401
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | 11713 |
| License Number State | AL |
VIII. Authorized Official
Name: MR.
MICHAEL
J
PARSONS
Title or Position: CEO PRESIDENT
Credential:
Phone: 205-868-4400