- Enrollment id
- O20060509000992
- Enrollment state
- FL
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1952337149
- Multiple npi flag
- N
- Ccn
- 101537
- Associate id
- 1153332879
- Organization name
- HOSPICE OF THE EMERALD COAST, INC.
- Doing business as name
- EMERALD COAST HOSPICE
- Incorporation date
- 1999-12-13
- Incorporation state
- FL
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 401 E 23RD ST
- Address line 2
- STE C
- City
- PANAMA CITY
- State
- FL
- Zip code
- 324057616