- Enrollment id
- O20070828000255
- Enrollment state
- AL
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1639112410
- Multiple npi flag
- N
- Ccn
- 011655
- Associate id
- 8527977735
- Organization name
- SOUTHERNCARE, INC.
- Doing business as name
- SOUTHERNCARE GREENVILLE
- Incorporation date
- 2002-12-30
- Incorporation state
- DE
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 501 E COMMERCE ST
- City
- GREENVILLE
- State
- AL
- Zip code
- 360372313