Provider Demographics
NPI:1508812447
Name:HOSPICE SAVANNAH, INC
Entity Type:Organization
Organization Name:HOSPICE SAVANNAH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:DELOACH
Authorized Official - Last Name:BENTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-629-1020
Mailing Address - Street 1:1352 EISENHOWER DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3902
Mailing Address - Country:US
Mailing Address - Phone:912-355-2289
Mailing Address - Fax:912-355-2376
Practice Address - Street 1:1352 EISENHOWER DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3902
Practice Address - Country:US
Practice Address - Phone:912-355-2289
Practice Address - Fax:912-355-2376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00371764AMedicaid
GA00371764AMedicaid