Provider Demographics
NPI:1841228053
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./ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:BRAMLETT-MARMANDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-435-7460
Mailing Address - Street 1:3290 DAUPHIN ST
Mailing Address - Street 2:SUITE 505
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-4062
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:2006-06-28
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11627385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPIC1594EMedicaid
ALPIC1594EMedicaid