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ALLIANCE HOSPICE LLC NPI 1043303753


NPI Information

NPI: 1043303753
Provider Name: ALLIANCE HOSPICE LLC

Doing Business As: CRESCENT HOSPICE

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

CLIA Number: 11D1048677

Address:
621 NW FRONTAGE RD STE 101
AUGUSTA, GA
ZIP 30907
Phone: (706) 447-2461
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ALLIANCE HOSPICE LLC is a hospice care community based in Augusta, GA. ALLIANCE HOSPICE LLC NPI is 1043303753. The provider is registered as an organization entity type.
The provider Is Doing Business As Crescent Hospice.

The provider's business location address is:

621 NW FRONTAGE RD STE 101
AUGUSTA, GA
ZIP 30907-964
Phone: (706) 447-2461
Fax: (706) 447-2465

The provider's authorized official is John Bradley Hunter .
The authorized official title is President And Ceo and has the following contact phone number (434) 290-3724.

The CLIA number assigned to this NPI record is 11D1048677 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/2/2006 and was last updated on 4/18/2024.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251G00000XHospice Care, Community Based11-1631GEORGIAYes

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
1041396802AMEDICAIDGEORGIA

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

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