Basic Information
| Provider Information | |||||||||
| NPI: | 1598838054 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOSPICE OF EAST ALABAMA MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 665 OPELIKA RD | ||||||||
| Address2: | |||||||||
| City: | AUBURN | ||||||||
| State: | AL | ||||||||
| PostalCode: | 368304013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3348261899 | ||||||||
| FaxNumber: | 3348218894 | ||||||||
| Practice Location | |||||||||
| Address1: | 665 OPELIKA RD | ||||||||
| Address2: | |||||||||
| City: | AUBURN | ||||||||
| State: | AL | ||||||||
| PostalCode: | 368304013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3348261899 | ||||||||
| FaxNumber: | 3348218894 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | MURPHEY | ||||||||
| AuthorizedOfficialFirstName: | CAROL | ||||||||
| AuthorizedOfficialMiddleName: | P. | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 3348261899 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | RN | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251G00000X | 11693 | AL | Y | Agencies | Hospice Care, Community Based |
ID Information
| ID | Type | State | Issuer | Description | PIC1528E | 05 | AL | MEDICAID | 010499 | 01 | AL | BLUECROSS BLUESHIELD | OTHER |