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General NPI Number Information
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NPI Number | 1750320180
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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 | 06/04/2006
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Last Update Date | 05/16/2016
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Provider Practice Location Address
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Address Line | 7067 SYDNEY CURV SUITE B
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City | MONTGOMERY
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State | AL
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Zip | 36117-3509
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Country | US
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Telephone | 334-260-2273
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Fax | 334-260-2274
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Provider Business Mailing Address
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Address Line | 655 BRAWLEY SCHOOL RD SUITE 200
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City | MOORESVILLE
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State | NC
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Zip | 28117-9125
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Country | US
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Telephone | 704-664-2876
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Fax | 704-664-1306
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Authorized Official
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Title or Position | VP OF LEGAL AFFAIRS
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Name | JESSICA KLEBERG
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Credential |
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Telephone | 704-664-2876
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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 | 10259
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License Number State | AL
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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 | 10529
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License Number State | AL
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