Healthcare Provider Details

I. General information

NPI: 1811935554
Provider Name (Legal Business Name): UNITED HOSPICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 E DOYLE ST
TOCCOA GA
30577-2107
US

IV. Provider business mailing address

409 E DOYLE ST
TOCCOA GA
30577-2107
US

V. Phone/Fax

Practice location:
  • Phone: 706-886-8493
  • Fax: 706-827-2048
Mailing address:
  • Phone: 706-886-8493
  • Fax: 706-827-2048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: NEIL L PRUITT JR.
Title or Position: CHAIRMAN AND CEO
Credential:
Phone: 770-925-1143