Healthcare Provider Details

I. General information

NPI: 1205022480
Provider Name (Legal Business Name): ALIVE HOSPICE AT ST. THOMAS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 09/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1718 PATTERSON ST
NASHVILLE TN
37203-2926
US

IV. Provider business mailing address

1718 PATTERSON ST
NASHVILLE TN
37203-2926
US

V. Phone/Fax

Practice location:
  • Phone: 615-327-1085
  • Fax:
Mailing address:
  • Phone: 615-327-1085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number0000000324
License Number StateTN

VIII. Authorized Official

Name: MRS. JAN JONES
Title or Position: CEO
Credential:
Phone: 615-327-1085