# IVY CREEK PALLIATIVE CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639776420
- **Authorized official:** MICHAEL D BRUCE CEO (CEO)
- **Authorized official phone:** (334) 567-4311

## Contact information

- **Practice address:** 525 HOSPITAL DR STE B, WETUMPKA, AL 36092-1626
- **Practice address phone:** (334) 567-5626
- **Mailing address:** PO BOX 130, WETUMPKA, AL 36092-0003

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QH0002X | Hospice and Palliative Medicine (Family Medicine) Physician | — | NULL | Yes |
| 207QH0002X | Hospice and Palliative Medicine (Family Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/05/2020
- **Last updated:** 10/05/2020