Provider Demographics
NPI:1699028357
Name:SOUTH BUTLER MEDICAL SERVICES LLC
Entity Type:Organization
Organization Name:SOUTH BUTLER MEDICAL SERVICES LLC
Other - Org Name:RELIABLEHOSPICE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:NMI
Authorized Official - Last Name:COLE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:334-376-2963
Mailing Address - Street 1:P.O. BOX 735
Mailing Address - Street 2:435 MEETING STREET
Mailing Address - City:GEORGIANA
Mailing Address - State:AL
Mailing Address - Zip Code:36033-0723
Mailing Address - Country:US
Mailing Address - Phone:334-376-2286
Mailing Address - Fax:334-376-3661
Practice Address - Street 1:435 MEETING STREET
Practice Address - Street 2:
Practice Address - City:GEORGIANA
Practice Address - State:AL
Practice Address - Zip Code:36033-0723
Practice Address - Country:US
Practice Address - Phone:334-376-2286
Practice Address - Fax:334-376-3661
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTH BUTLER MEDICAL SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based