MEDICARE: JOURNEY HOSPICE OF ALABAMA,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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1093126716
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOURNEY HOSPICE OF ALABAMA,LLC

Provider Business Mailing Address
First Line	:	4128 CROSSHAVEN DR
Second Line	:
City	:	VESTAVIA
State	:	AL
Zip	:	35243-5228
Country	:	US
Telephone Number	:	901-351-1450
Fax Number	:

Provider Business Practice Location Address
First Line	:	4128 CROSSHAVEN DR
Second Line	:
City	:	VESTAVIA
State	:	AL
Zip	:	35243-5228
Country	:	US
Telephone Number	:	901-351-1450
Fax Number	:

Authorized Official
Title or Position	:	CHIEF MANAGER
Name	:	MR. RICHARD KYLE RICE SR.
Credential	:	NONE
Telephone Number	:	901-351-1450

Provider Enumeration Date	:	05/15/2014
Last Update Date	:	01/05/2015

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