Organization Name: | GOOD SAMARITAN HOSPICE USA INC |
NPI Number: | 1396767224 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JACKIE RANDOLPH GIST (PRESIDENT) |
Mailing Address: | 402 E Dr Hicks Blvd Florence |
State: | AL US |
Postal Code: | 356305763 |
Phone Number: | 2567674799 |
Fax Number: | 2567674798 |
NPI Enumeration Date: | 07/23/2006 |
NPI Last Update Date: | 06/26/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | 12948 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |