Basic Information
Provider Information
NPI: 1134109515
EntityType: 2
ReplacementNPI:  
OrganizationName: SPRINGHILL MEMORIAL HOSPICE
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3632 DAUPHIN ST
Address2: 101 B
City: MOBILE
State: AL
PostalCode: 366081247
CountryCode: US
TelephoneNumber: 2514605280
FaxNumber:  
Practice Location
Address1: 3719 DAUPHIN ST
Address2:  
City: MOBILE
State: AL
PostalCode: 366081753
CountryCode: US
TelephoneNumber: 2513449630
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/20/2006
LastUpdateDate: 03/11/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: GRIGSBY
AuthorizedOfficialFirstName: STEPHEN
AuthorizedOfficialMiddleName: JANQ
AuthorizedOfficialTitleorPosition: VP/CFO
AuthorizedOfficialTelephone: 2514605220
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: SPRINGHILL HOSPITALS, INC.
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/11/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
315D00000X  Y Nursing & Custodial Care FacilitiesHospice, Inpatient 

No ID Information.


Home