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General NPI Number Information
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NPI Number | 1548501000
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Entity Type | Organization
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Legal Business Name | BETHANY HOSPICE AND PALLIATIVE CARE OF COASTAL GEORGIA, LLC
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Dates
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Enumeration Date | 03/08/2013
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 109 S DUVAL ST
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City | CLAXTON
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State | GA
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Zip | 30417-2029
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Country | US
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Telephone | 912-739-0058
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Fax | 912-739-0350
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Provider Business Mailing Address
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Address Line | 135 GEMINI CIR STE 202
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City | BIRMINGHAM
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State | AL
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Zip | 35209-5842
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Country | US
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Telephone | 912-739-0058
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Fax | 912-739-0350
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Authorized Official
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Title or Position | CEO
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Name | MR. CHRISTOPHER SMITH
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Credential |
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Telephone | 205-949-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | 054-0285-H
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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 | 054-0285-H
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License Number State | GA
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