Provider Demographics
NPI:1649235805
Name:INFIRMARY HOSPICE CARE INC
Entity Type:Organization
Organization Name:INFIRMARY HOSPICE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRES/ADMIN
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:SUSANNE
Authorized Official - Last Name:BRAMLETT-MARMANDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-435-7460
Mailing Address - Street 1:PO BOX 2226
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36652-2226
Mailing Address - Country:US
Mailing Address - Phone:251-435-7460
Mailing Address - Fax:251-435-7499
Practice Address - Street 1:3290 DAUPHIN ST
Practice Address - Street 2:SUITE 505
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-4062
Practice Address - Country:US
Practice Address - Phone:251-435-7460
Practice Address - Fax:251-435-7499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALE4905251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPIC1558EMedicaid
AL011558Medicare ID - Type Unspecified