LEGACY HOSPICE GA LLC NPI 1477153492

NPI Information

NPI: 1477153492
Provider Name: LEGACY HOSPICE GA, LLC

Doing Business As: COASTAL HOSPICE OF GEORGIA

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization
Address:
106 SHOPPERS WAY STE 111
BRUNSWICK, GA
ZIP 31525
Phone: (912) 434-9810
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LEGACY HOSPICE GA, LLC is a hospice care community based in Brunswick, GA. LEGACY HOSPICE GA, LLC NPI is 1477153492. The provider is registered as an organization entity type.
The provider Is Doing Business As Coastal Hospice Of Georgia.

The provider's business location address is:

106 SHOPPERS WAY STE 111
BRUNSWICK, GA
ZIP 31525-522
Phone: (912) 434-9810
Fax: (912) 434-9752

The provider's authorized official is Donnie Maberry .
The authorized official title is Executive Vice President and has the following contact phone number (972) 468-8070.

The enumeration date for this NPI number is 10/28/2020 and was last updated on 3/27/2024.

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				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	003250312A	MEDICAID	GEORGIA
2	11D2210199	OTHER	GEORGIA	CLIA
3	HSPC001445	OTHER	GEORGIA	STATE OPERATOR'S LICENSE #

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: 5/5/2024

NPI Synchronization or Removal

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