Provider Demographics
NPI:1194727362
Name:HOSPICE OF MARSHALL COUNTY, INC.
Entity type:Organization
Organization Name:HOSPICE OF MARSHALL COUNTY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:SLATON
Authorized Official - Last Name:OSBORNE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:256-891-7724
Mailing Address - Street 1:408 MARTLING RD
Mailing Address - Street 2:
Mailing Address - City:ALBERTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35951-0000
Mailing Address - Country:US
Mailing Address - Phone:256-891-7724
Mailing Address - Fax:256-891-7754
Practice Address - Street 1:408 MARTLING ROAD
Practice Address - Street 2:
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35951-0000
Practice Address - Country:US
Practice Address - Phone:256-891-7724
Practice Address - Fax:256-891-7754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10248251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL010353OtherBLUECROSSBLUESHIELD OF AL
ALPIC1513EMedicaid
AL011513Medicare ID - Type Unspecified