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General NPI Number Information
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NPI Number | 1619083391
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Entity Type | Organization
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Legal Business Name | HOSPICE OF TENNESSEE VALLEY, INC.
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 11/21/2008
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Provider Practice Location Address
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Address Line | 200 WEST TENNESSEE STREET
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City | FLORENCE
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State | AL
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Zip | 35630
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Country | US
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Telephone | 256-767-1322
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Fax | 256-718-0077
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Provider Business Mailing Address
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Address Line | 200 WEST TENNESSEE STREET
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City | FLORENCE
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State | AL
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Zip | 35630
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Country | US
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Telephone | 256-767-1322
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Fax | 256-718-0077
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JOHN BLAKE EDWARDS
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Credential |
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Telephone | 256-767-1322
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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 | 12844
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License Number State | AL
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