Provider Demographics
NPI:1184258485
Name:SOUTHERN COMFORT IN-HOME CARE
Entity type:Organization
Organization Name:SOUTHERN COMFORT IN-HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BLOCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-222-0100
Mailing Address - Street 1:26091 SHOEMAKER RD
Mailing Address - Street 2:
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36421-5903
Mailing Address - Country:US
Mailing Address - Phone:334-222-0100
Mailing Address - Fax:
Practice Address - Street 1:26091 SHOEMAKER RD
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36421-5903
Practice Address - Country:US
Practice Address - Phone:334-222-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-25
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty