1447297981 NPI number — ASERACARE HOSPICE - HAMILITON, LLC

Table of content: (NPI 1447297981)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447297981 NPI number — ASERACARE HOSPICE - HAMILITON, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASERACARE HOSPICE - HAMILITON, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ASERACARE HOSPICE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447297981
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/25/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1215 MILITARY ST S
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
HAMILTON
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35570-5004
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-758-1450
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1215 MILITARY ST S
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
HAMILTON
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35570-5004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-758-1450
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/01/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RASMUSSEN-JONES
Authorized Official First Name:
HOLLY
Authorized Official Middle Name:
A
Authorized Official Title or Position:
SECRETARY
Authorized Official Telephone Number:
479-201-4835

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 012-498 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 201187918 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: PIC-1586E , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".