- Enrollment id
- O20171027000608
- Enrollment state
- AL
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1699202341
- Multiple npi flag
- N
- Ccn
- 011685
- Associate id
- 2668365859
- Organization name
- MONROE COUNTY HEALTH CARE AUTHORITY
- Doing business as name
- HOSPICE OF MONROE COUNTY
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 2016 S ALABAMA AVE
- City
- MONROEVILLE
- State
- AL
- Zip code
- 364603044