1144381179 NPI number — DAYSPRING HOSPICE, LLC

Table of content: (NPI 1144381179)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144381179 NPI number — DAYSPRING HOSPICE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DAYSPRING HOSPICE, 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:
Provider Other Organization Name Type Code:
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:
1144381179
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/20/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 311246
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ENTERPRISE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36331-1246
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
334-347-2999
Provider Business Mailing Address Fax Number:
334-347-2980

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 PROFESSIONAL LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ENTERPRISE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36330-2393
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-347-2999
Provider Business Practice Location Address Fax Number:
334-347-2980
Provider Enumeration Date:
12/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HENDRIX
Authorized Official First Name:
DONNA
Authorized Official Middle Name:
R
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
334-347-2999

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  11632 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: PIC1603E , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com