Organization
WIREGRASS HOSPICE, LLC
Active
Other names
Gentiva
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANET COMBS (VP OF LICENSURE)
(704) 662-1761
Entity
Organization
Contact information
Practice address
432 E SHOTWELL ST, BAINBRIDGE, GA 39819-4058
(229) 246-6330
(229) 248-1679
Mailing address
PO BOX 4060, MOORESVILLE, NC 28117-4060
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000641154A
—
GA
01
—
26-0101886
G2
—
01
—
51422605
G2
—
Enumeration date
06/24/2006
Last updated
01/17/2023
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