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General NPI Number Information
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NPI Number | 1790784312
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Entity Type | Organization
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Legal Business Name | HOSPICE OF SOUTHERN KENTUCKY, INC
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Dates
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Enumeration Date | 07/15/2005
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 5872 SCOTTSVILLE RD
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City | BOWLING GREEN
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State | KY
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Zip | 42104-7853
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Country | US
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Telephone | 270-746-9300
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Fax | 270-782-3496
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Provider Business Mailing Address
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Address Line | 5872 SCOTTSVILLE RD
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City | BOWLING GREEN
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State | KY
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Zip | 42104-7853
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Country | US
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Telephone | 270-782-3402
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Fax | 270-782-0588
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. STEVEN JANTZ
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Credential |
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Telephone | 270-746-9300
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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 |
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License Number State |
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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 | 400006
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License Number State | KY
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Taxonomy #3
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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 | KY
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