SOUTHERNCARE INC. NPI 1700826211

NPI Information

NPI: 1700826211
Provider Name: SOUTHERNCARE, INC.

Doing Business As: GENTIVA II

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

CLIA Number: 39D2051249

Address:
1701 12TH AVE STE D
ALTOONA, PA
ZIP 16601
Phone: (814) 944-9724
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SOUTHERNCARE, INC. is a hospice care community based in Altoona, PA. SOUTHERNCARE, INC. NPI is 1700826211. The provider is registered as an organization entity type.
The provider Is Doing Business As Gentiva Ii.

The provider's business location address is:

1701 12TH AVE STE D
ALTOONA, PA
ZIP 16601-100
Phone: (814) 944-9724
Fax: (814) 944-9727

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 39D2051249 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/7/2006 and was last updated on 1/17/2023.

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		16571601	PENNSYLVANIA	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
1	1008904340010	MEDICAID	PENNSYLVANIA
2	00890434000	MEDICAID	PENNSYLVANIA
3	1008904340003	MEDICAID	PENNSYLVANIA

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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