1669663472 NPI number — HOSPICE COMPLETE, INC

Table of content: (NPI 1669663472)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669663472 NPI number — HOSPICE COMPLETE, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOSPICE COMPLETE, INC
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:
6
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:
1669663472
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/03/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2153 RIVERCHASE OFFICE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35244-1836
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-988-8669
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3064 PALISADES CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUSCALOOSA
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35405-3446
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-633-3705
Provider Business Practice Location Address Fax Number:
205-633-3755
Provider Enumeration Date:
08/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MILLER
Authorized Official First Name:
KEVIN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
205-988-8669

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: E6306 . This is a "STATE LICENSE" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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