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General NPI Number Information
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NPI Number | 1568401511
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Entity Type | Organization
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Legal Business Name | SOUTHERNCARE, INC
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 07/12/2007
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Provider Practice Location Address
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Address Line | 6711 S YALE AVE
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City | TULSA
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State | OK
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Zip | 74136-3313
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Country | US
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Telephone | 918-499-8755
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Fax | 918-499-8725
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Provider Business Mailing Address
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Address Line | 3536 VANN RD
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City | BIRMINGHAM
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State | AL
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Zip | 35235-3221
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Country | US
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Telephone | 205-655-4809
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Fax | 205-655-0587
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL J. PARDY
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Credential |
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Telephone | 205-655-4809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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