Provider Demographics
NPI:1740228725
Name:SOUTHERN CARE INC
Entity Type:Organization
Organization Name:SOUTHERN CARE INC
Other - Org Name:SOUTHERN CARE JASPER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:PARDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-655-4809
Mailing Address - Street 1:3536 VANN ROAD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235
Mailing Address - Country:US
Mailing Address - Phone:205-655-4809
Mailing Address - Fax:205-655-0587
Practice Address - Street 1:4330 HWY 78 EAST
Practice Address - Street 2:STE 210 & 211
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35504
Practice Address - Country:US
Practice Address - Phone:205-387-0249
Practice Address - Fax:205-387-0681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11076163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH1000XNursing Service ProvidersRegistered NurseHospiceGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPIC1625EMedicaid
ALPIC1625EMedicaid