Provider Demographics
NPI:1508434408
Name:HOSPICE SATILLA OF MEMORIAL HOSPITAL INC
Entity Type:Organization
Organization Name:HOSPICE SATILLA OF MEMORIAL HOSPITAL INC
Other - Org Name:SATILLA PALLIATIVE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:THRIFT
Authorized Official - Last Name:GOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-285-2340
Mailing Address - Street 1:808 EVERGREEN WAY
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31501-7102
Mailing Address - Country:US
Mailing Address - Phone:912-285-2340
Mailing Address - Fax:912-283-0200
Practice Address - Street 1:808 EVERGREEN WAY
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31501-7102
Practice Address - Country:US
Practice Address - Phone:912-285-2340
Practice Address - Fax:912-283-0200
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOSPICE SATILLA OF MEMORIAL HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-16
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty