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1225457757 NPI number — PALLIATIVE AND SUPPORTIVE CARE ALLIANCE, INC

NPI Number: 1225457757
Health Care Provider/Practitioner: PALLIATIVE AND SUPPORTIVE CARE ALLIANCE, INC

Information about “1225457757” NPI (PALLIATIVE AND SUPPORTIVE CARE ALLIANCE, INC) exists in 1225457757 in HTML format HTML  |  1225457757 in plain Text format TXT  |  1225457757 in PDF (Portable Document Format) PDF  |  1225457757 in an XML format XML  formats.

NPI Number : 1225457757 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1225457757",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PALLIATIVE AND SUPPORTIVE CARE ALLIANCE, INC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "408 MARTLING RD STE A-105",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ALBERTVILLE",
    "MailingAddressStateName": "AL",
    "MailingAddressPostalCode": "35951-7208",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "256-302-1663",
    "MailingAddressFaxNumber": "256-279-0534",
    "FirstLinePracticeLocationAddress": "408 MARTLING RD STE A-105",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ALBERTVILLE",
    "PracticeLocationAddressStateName": "AL",
    "PracticeLocationAddressPostalCode": "35951-7208",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "256-302-1663",
    "PracticeLocationAddressFaxNumber": "256-279-0534",
    "EnumerationDate": "04/11/2014",
    "LastUpdateDate": "04/29/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "DISMUKE",
    "AuthorizedOfficialFirstName": "STORMY",
    "AuthorizedOfficialMiddleName": "DENISE",
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": "MRS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "CRNP",
    "AuthorizedOfficialTelephoneNumber": "256-302-1633",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207QH0002X",
        "TaxonomyName": "Hospice and Palliative Medicine (Family Medicine) Physician",
        "LicenseNumber": "1-084124",
        "LicenseNumberStateCode": "AL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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