ST. JOSEPH HOSPICE LLC NPI 1275836082

NPI Information

NPI: 1275836082
Provider Name: ST. JOSEPH HOSPICE, LLC
Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

CLIA Number: 11D2034041

Address:
1231 AUGUSTA WEST PKWY
AUGUSTA, GA
ZIP 30909
Phone: (706) 922-7480
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ST. JOSEPH HOSPICE, LLC is a hospice care community based in Augusta, GA. ST. JOSEPH HOSPICE, LLC NPI is 1275836082. The provider is registered as an organization entity type.

The provider's business location address is:

1231 AUGUSTA WEST PKWY
AUGUSTA, GA
ZIP 30909-807
Phone: (706) 922-7480
Fax: (706) 364-3285

The provider's authorized official is Susan Martin Bruce .
The authorized official title is Ceo and has the following contact phone number (706) 922-7480.

The CLIA number assigned to this NPI record is 11D2034041 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/16/2010 and was last updated on 5/30/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251G00000X	Hospice Care, Community Based		APPLIED FOR	SOUTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	HSP136	MEDICAID	SOUTH CAROLINA
2	003126081A	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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