MEDICARE: ASERACARE HOSPICE - BIRMINGHAM, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	315D00000X	Inpatient Hospice

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0212-497	OTHER		BCBS

General Provider Information

NPI Number	:	1013954528
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASERACARE HOSPICE - BIRMINGHAM, LLC

Provider Business Mailing Address
First Line	:	450 CENTURY PARK S
Second Line	:	SUITE 112B
City	:	HOOVER
State	:	AL
Zip	:	35226-3941
Country	:	US
Telephone Number	:	901-758-1450
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 CENTURY PARK S
Second Line	:	SUITE 112B
City	:	HOOVER
State	:	AL
Zip	:	35226-3941
Country	:	US
Telephone Number	:	901-758-1450
Fax Number	:

Authorized Official
Title or Position	:	SECRETARY
Name	:	HOLLY A JONES
Credential	:
Telephone Number	:	479-201-4840

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	08/22/2020

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