COUNTRYSIDE HOSPICE CARE INC (NPI# 1790723211) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790723211 |
| Entity Type | Organization |
| Organization Name | COUNTRYSIDE HOSPICE CARE INC |
| Other Organization Name | SOLAMORE HOSPICE JACKSONVILLE |
| Practice Address |
320 Branscomb Dr Sw Suite D Jacksonville AL 36265 |
| Mailing Address |
101 Sun Ave Ne Albuquerque NM 87109-4373 |
| Practice Telephone | 2562352999 |
| Practice Fax Number | 2567823590 |
| Mailing Telephone | 5054685604 |
| Mailing Fax Number | 5054684681 |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2011-08-03 |
| Authorized Official Name | MR. GLEN CAVALLO (SR. VP OF OPERATIONS) |
| Authorized Official Telephone | 4799965900 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOLAMOR HOSPICE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251G00000X | Hospice Care, Community Based | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | PIC1579E | 05 |
| Other Name | Type Code |
|---|---|
| SolAmore Hospice Jacksonville | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710925227 | Countryside Hospice Care Inc | Hospice Care, Community Based | 3355 Highway 431, Suite 3, Roanoke, AL 36274-2723 | 2006-06-04 |
| 1275571259 | Countryside Hospice Care Inc | Hospice Care, Community Based | 955 S Three Notch St, Andalusia, AL 36420-5231 | 2006-06-03 |
| 1639117690 | Countryside Hospice Care Inc | Hospice Care, Community Based | 820 Ebenezer Church Rd, Suite 106, Sharpsburg, GA 30277-2073 | 2006-06-03 |
| 1619914082 | Countryside Hospice Care Inc | Hospice Care, Community Based | 13521 Shelby County 280, Suite 253, Birmingham, AL 35242 | 2006-06-02 |
| 1265470249 | Countryside Hospice Care Inc | Hospice Care, Community Based | 106 Pearl Dr, Suite 107, La Fayette, GA 30728-7509 | 2006-06-03 |
| Street Address |
320 BRANSCOMB DR SW SUITE D |
| City | JACKSONVILLE |
| State | AL |
| Zip Code | 36265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780068460 | Surgery Clinic, LLC | Surgery | 320 Branscomb Dr Sw, Suite B, Jacksonville, AL 36265-3101 | 2015-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700436144 | Griffin Loflin | Specialist/Technologist | 775 Park Ave Nw, Attn. Sports Medicine, Jacksonville, AL 36265 | 2019-09-17 |
| 1114304011 | Caroline Ross | Counselor | 1215 Jackson Way Sw, Jacksonville, AL 36265 | 2015-04-29 |
| 1083001226 | Tracey Hudgins | Counselor | 1215 Jackson's Way, Jacksonville, AL 36265 | 2015-04-24 |
| 1235415118 | Adam Pike | Pharmacist | 311 Pelham Rd So, Jacksonville, AL 36265 | 2011-10-24 |
| 1386829489 | Physicians Choice Dialysis of Jacksonville, LLC | Clinic/Center | 331 Henry Road Sw, Jacksonville, AL 36265 | 2008-01-08 |
| 1659409365 | Kenneth Wayne Campbell | Nurse Anesthetist, Certified Registered | 1701 Pelham Road, Jacksonville Medical Center, Jacksonville, AL 36265 | 2007-03-02 |
| 1154478378 | Diana C. Ford | Counselor | 1250 Jackson's Way, Garrett Counseling Center, Jacksonville, AL 36265 | 2007-01-03 |
| 1487710950 | James Richard Morrison | Chiropractor | 1550 Pelham Rd. S., Jacksonville, AL 36265 | 2006-12-29 |
| 1447332937 | Millennium Anesthesia Services | Anesthesiology | 1701 Pelham Road S, Jacksonville, AL 36265 | 2006-10-20 |
| 1407943228 | Brunda Revanna, Md | Clinic/Center | 1465 A 1st Ave Sw Ste C, Jacksonville, AL 36265 | 2006-10-05 |
| Find all providers in zip 36265 | ||||
| Taxonomy Code | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
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| 1356953483 | Wellness Homecare LLC | Hospice Care, Community Based | 4320 Sunbeam Rd Apt 315, Jacksonville, FL 32257-8829 | 2020-08-19 |
| 1689282592 | Amzn Eco LLC | Hospice Care, Community Based | 5610 Fort Caroline Rd Ste 6, Jacksonville, FL 32277-1794 | 2020-07-16 |
| 1174150452 | Sls Caring Hands | Hospice Care, Community Based | 8767 Norfolk Blvd, Jacksonville, FL 32208-1915 | 2020-03-25 |
| 1750865945 | A Plus Developmental Support Services LLC | Hospice Care, Community Based | 6606 Romilly Dr, Jacksonville, FL 32210-7139 | 2018-09-24 |
| 1790045995 | Comfortzone Agency Inc | Hospice Care, Community Based | 426 E 3rd St, Jacksonville, FL 32206-5116 | 2012-05-22 |
| 1902181944 | Hospice of Massachusetts, LLC | Hospice Care, Community Based | 50 N Laura St, Suite 1800, Jacksonville, FL 32202-3664 | 2011-10-20 |
| 1144459421 | Anntoinette Campbell | Hospice Care, Community Based | 7555 Beach Blvd Ste 200, Jacksonville, FL 32216-3003 | 2009-07-08 |
| 1275666273 | Hcr Manor Care Services of Florida, LLC | Hospice Care, Community Based | 8130 Baymeadows Way W, Suite 201, Jacksonville, FL 32256-7451 | 2007-03-13 |
| 1295789568 | Continuum II Home Care & Hospice, Inc. | Hospice Care, Community Based | 3886 Henderson Dr, Jacksonville, NC 28546-5219 | 2006-05-20 |
| 1841249976 | Continuum II Home Care and Hospice, Inc. | Hospice Care, Community Based | 3391 Henderson Dr, Jacksonville, NC 28546-5231 | 2006-05-08 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 36265 |
Please comment or provide details below to improve the information on COUNTRYSIDE HOSPICE CARE INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.