Provider Demographics
NPI:1992742431
Name:ASERACARE HOSPICE - MONROEVILLE, LLC
Entity type:Organization
Organization Name:ASERACARE HOSPICE - MONROEVILLE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:GINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-299-3726
Mailing Address - Street 1:3854 AMERICAN WAY STE A
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4897
Mailing Address - Country:US
Mailing Address - Phone:225-292-2031
Mailing Address - Fax:225-295-9678
Practice Address - Street 1:11 N WATER ST STE 11225
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36602-3809
Practice Address - Country:US
Practice Address - Phone:251-343-0989
Practice Address - Fax:251-343-0792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL200812171016251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
012-473OtherBCBS
AL134380Medicaid
ALPIC-1567EMedicaid