Organization
WIREGRASS HOSPICE, LLC
Active
Other names
Gentiva
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANET COMBS (VP OF LICENSURE)
(704) 664-2876
Entity
Organization
Contact information
Practice address
2431 W MAIN ST STE 1102, DOTHAN, AL 36301-1250
(334) 792-1100
(334) 671-4168
Mailing address
PO BOX 4060, MOORESVILLE, NC 28117-4060
(704) 664-2876
(704) 664-1306
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PIC 1014E
—
AL
05
—
PIC 1017E
—
AL
05
—
PIC 1018E
—
AL
05
—
PIC 1023E
—
AL
05
—
PIC 1024E
—
AL
05
—
PIC 1025E
—
AL
05
—
PIC 1026E
—
AL
05
—
PIC 1027E
—
AL
05
—
PIC 1522E
—
AL
Enumeration date
06/24/2006
Last updated
01/17/2023
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