Basic Information
| Provider Information | |||||||||
| NPI: | 1235438078 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNITY HOSPICE NE, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3085 FOUNTAINSIDE DR | ||||||||
| Address2: | STE 110 | ||||||||
| City: | GERMANTOWN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381387842 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9017567322 | ||||||||
| FaxNumber: | 9017567085 | ||||||||
| Practice Location | |||||||||
| Address1: | 3964 GOODMAN RD E | ||||||||
| Address2: | STE 112 | ||||||||
| City: | SOUTHAVEN | ||||||||
| State: | MS | ||||||||
| PostalCode: | 386728761 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6628935662 | ||||||||
| FaxNumber: | 6628935665 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/18/2011 | ||||||||
| LastUpdateDate: | 04/01/2011 | ||||||||
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| AuthorizedOfficialLastName: | FOURNIER | ||||||||
| AuthorizedOfficialFirstName: | BOB | ||||||||
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| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9017567322 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251G00000X | Y | Agencies | Hospice Care, Community Based |
No ID Information.