MEDICARE: STEM,INC.

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	:	1558624551
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEM,INC.

Provider Business Mailing Address
First Line	:	8198 STERLING LN
Second Line	:
City	:	COVINGTON
State	:	GA
Zip	:	30014
Country	:	US
Telephone Number	:	912-980-5356
Fax Number	:

Provider Business Practice Location Address
First Line	:	8198 STERLING LN
Second Line	:
City	:	COVINGTON
State	:	GA
Zip	:	30014-3785
Country	:	US
Telephone Number	:	912-980-5356
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MS. MICHELE LEA BAGBY
Credential	:
Telephone Number	:	912-980-5356

Provider Enumeration Date	:	06/25/2012
Last Update Date	:	06/25/2012

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