Provider Type Icon

SOUTHERNCARE INC. NPI 1851330641


NPI Information

NPI: 1851330641
Provider Name: SOUTHERNCARE, INC.

Doing Business As: GENTIVA

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

CLIA Number: 25D2050524

Address:
706 HIGHWAY 51 N
BROOKHAVEN, MS
ZIP 39601
Phone: (601) 990-2315
Get Directions

SOUTHERNCARE, INC. is a hospice care community based in Brookhaven, MS. SOUTHERNCARE, INC. NPI is 1851330641. The provider is registered as an organization entity type.
The provider Is Doing Business As Gentiva.

The provider's business location address is:

706 HIGHWAY 51 N
BROOKHAVEN, MS
ZIP 39601-366
Phone: (601) 990-2315
Fax: (601) 579-9495

The provider's authorized official is Janet Combs .
The authorized official title is Vp Of Licensure and has the following contact phone number (704) 664-2876.

The CLIA number assigned to this NPI record is 25D2050524 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/6/2006 and was last updated on 4/21/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251G00000XHospice Care, Community Based062MISSISSIPPIYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100770378MEDICAIDMISSISSIPPI

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.