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General NPI Number Information
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NPI Number | 1497832844
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Entity Type | Organization
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Legal Business Name | SOUTHERN COMMUNITY HOSPICE, INC.
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 904 MOUNT VERNON RD
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City | VIDALIA
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State | GA
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Zip | 30474-3030
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Country | US
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Telephone | 912-537-0063
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Fax | 912-537-2005
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Provider Business Mailing Address
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Address Line | 715 LEGION DR
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City | EASTMAN
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State | GA
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Zip | 31023-6780
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Country | US
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Telephone | 478-374-4888
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Fax | 478-374-0504
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Authorized Official
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Title or Position | AUTHORIZED BILLING OFFICIAL
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Name | KRISTA HOWARD
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Credential |
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Telephone | 478-374-4888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315D00000X
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Taxonomy Name | Inpatient Hospice
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License Number | 138135H
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 138135H
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License Number State | GA
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