=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821017781
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FAMILY COMFORT HOSPICE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/19/2006
-----------------------------------------------------
Last Update Date | 07/20/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 341 WALKER CHAPEL PLAZA SUITE 105
-----------------------------------------------------
City | FULTONDALE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35068
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-502-5959
-----------------------------------------------------
Fax | 205-502-5966
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 341 WALKER CHAPEL PLAZA SUITE 105
-----------------------------------------------------
City | FULTONDALE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35068
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-502-5959
-----------------------------------------------------
Fax | 205-502-5966
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. HUGH LYNN MCMURRY
-----------------------------------------------------
Credential | CPA
-----------------------------------------------------
Telephone | 205-502-5959
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number | 011684
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------