Healthcare Provider Details

I. General information

NPI: 1972709160
Provider Name (Legal Business Name): BETHANY HOSPICE AND PALLIATIVE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2007
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 N OAK ST BUILDING B
VALDOSTA GA
31602-1772
US

IV. Provider business mailing address

135 GEMINI CIR STE 202
BIRMINGHAM AL
35209-5842
US

V. Phone/Fax

Practice location:
  • Phone: 229-249-8687
  • Fax: 229-249-9282
Mailing address:
  • Phone: 205-949-0400
  • Fax: 205-949-0405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number092-154-H
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number092-154-H
License Number StateGA

VIII. Authorized Official

Name: MR. CHRISTOPHER SMITH
Title or Position: CEO
Credential:
Phone: 205-949-0400