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General NPI Number Information
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NPI Number | 1205033354
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Entity Type | Organization
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Legal Business Name | SOUTHERN HOME CARE
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 08/28/2012
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Provider Practice Location Address
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Address Line | 1806 E 10TH ST
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130-6016
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Country | US
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Telephone | 502-581-8603
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Fax |
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Provider Business Mailing Address
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Address Line | 539 S 4TH ST
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City | LOUISVILLE
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State | KY
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Zip | 40202-2535
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Country | US
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Telephone | 502-581-8603
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Fax |
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Authorized Official
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Title or Position | BUSINESS UNIT CONTROLLER
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Name | CATHY KIDD
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Credential | PH.D.
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Telephone | 502-581-8603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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