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General NPI Number Information
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NPI Number | 1669144887
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Entity Type | Organization
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Legal Business Name | SOUTHCARE SPECIALTY SERVICES, LLC
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Dates
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Enumeration Date | 10/05/2021
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Last Update Date | 10/05/2021
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Provider Practice Location Address
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Address Line | 274 INTERSTATE HIGHWAY PARK LOOP
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City | PRATVILLE
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State | AL
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Zip | 36066
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Country | US
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Telephone | 334-801-9020
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Fax |
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Provider Business Mailing Address
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Address Line | 274 INTERSTATE HIGHWAY PARK LOOP
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City | PRATVILLE
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State | AL
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Zip | 36066
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Country | US
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Telephone | 334-801-9020
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Fax |
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Authorized Official
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Title or Position | EXEC. DIRECTOR / OWNER
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Name | DEBI J CASC
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Credential |
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Telephone | 334-790-2723
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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