Basic Information
| Provider Information | |||||||||
| NPI: | 1811935554 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | UNITED HOSPICE, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 409 E DOYLE ST | ||||||||
| Address2: | |||||||||
| City: | TOCCOA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 305772107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7068868493 | ||||||||
| FaxNumber: | 7068272048 | ||||||||
| Practice Location | |||||||||
| Address1: | 409 E DOYLE ST | ||||||||
| Address2: | |||||||||
| City: | TOCCOA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 305772107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7068868493 | ||||||||
| FaxNumber: | 7068272048 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | PRUITT | ||||||||
| AuthorizedOfficialFirstName: | NEIL | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | CHAIRMAN AND CEO | ||||||||
| AuthorizedOfficialTelephone: | 7709251143 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | JR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 315D00000X | Y | Nursing & Custodial Care Facilities | Hospice, Inpatient |
No ID Information.