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Organization
ASERACARE HOSPICE - JACKSON LLC
Active
Organization
ASERACARE HOSPICE - JACKSON LLC
Active
Other names
Prime by AseraCare
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL KUSSEROW (PRESIDENT)
(225) 292-2031
Entity
Organization
Contact information
Practice address
1201 MONTLIMAR DR, STE 100, MOBILE, AL 36609-1704
(251) 343-0989
Mailing address
3854 AMERICAN WAY STE A, BATON ROUGE, LA 70816-4897
(225) 292-2031
(225) 295-9678
Taxonomy
Speciality
Code
Description
License number
State
207PH0002X
Hospice and Palliative Medicine (Emergency Medicine) Physician
—
NULL
207PH0002X
Hospice and Palliative Medicine (Emergency Medicine) Physician
—
—
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
—
NULL
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
—
—
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
—
NULL
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
—
—
2081H0002X
Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
—
NULL
2081H0002X
Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
—
—
Other
Enumeration date
11/12/2013
Last updated
07/06/2020
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