COUNTRYSIDE HOSPICE CARE INC (NPI# 1639117690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639117690 |
| Entity Type | Organization |
| Organization Name | COUNTRYSIDE HOSPICE CARE INC |
| Other Organization Name | SOLAMOR HOSPICE SHARPSBURG |
| Practice Address |
820 Ebenezer Church Rd Suite 106 Sharpsburg GA 30277-2073 |
| Mailing Address |
101 Sun Ave Ne Albuquerque NM 87109-4373 |
| Practice Telephone | 7702524999 |
| Practice Fax Number | 7702524743 |
| Mailing Telephone | 5054685604 |
| Mailing Fax Number | 5054684681 |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2012-02-16 |
| Authorized Official Name | MR. GLEN CAVALLO (SR. VP - OPERATIONS) |
| Authorized Official Telephone | 4799965900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251G00000X | Hospice Care, Community Based | 038156H | GA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00894132A | 05 | |
| GA | GEORGIA HOSPICE LICENSE | 038156H | 01 |
| Other Name | Type Code |
|---|---|
| SolAmor Hospice Sharpsburg | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710925227 | Countryside Hospice Care Inc | Hospice Care, Community Based | 3355 Highway 431, Suite 3, Roanoke, AL 36274-2723 | 2006-06-04 |
| 1790723211 | Countryside Hospice Care Inc | Hospice Care, Community Based | 320 Branscomb Dr Sw, Suite D, Jacksonville, AL 36265 | 2006-06-04 |
| 1275571259 | Countryside Hospice Care Inc | Hospice Care, Community Based | 955 S Three Notch St, Andalusia, AL 36420-5231 | 2006-06-03 |
| 1619914082 | Countryside Hospice Care Inc | Hospice Care, Community Based | 13521 Shelby County 280, Suite 253, Birmingham, AL 35242 | 2006-06-02 |
| 1265470249 | Countryside Hospice Care Inc | Hospice Care, Community Based | 106 Pearl Dr, Suite 107, La Fayette, GA 30728-7509 | 2006-06-03 |
| Street Address |
820 EBENEZER CHURCH RD SUITE 106 |
| City | SHARPSBURG |
| State | GA |
| Zip Code | 30277-2073 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245697333 | Travis John Humber | Chiropractor | 820 Ebenezer Church Rd, Sharpsburg, GA 30277-2073 | 2016-01-21 |
| 1245579234 | Atlas Integrative Medicine and Spine Center LLC | Nurse Practitioner | 820 Ebenezer Church Rd, Sharpsburg, GA 30277-2073 | 2013-02-11 |
| 1154690345 | Julie Renee Evans | Counselor | 820 Ebenezer Church Rd, Suite 110, Sharpsburg, GA 30277-2073 | 2011-12-19 |
| 1669691846 | Glenn W Howell | Chiropractor | 820 Ebenezer Church Rd, Suite 100, Sharpsburg, GA 30277-2073 | 2007-04-25 |
| 1396964565 | Thomas M Humber | Chiropractor | 820 Ebenezer Church Rd, Suite 100, Sharpsburg, GA 30277-2073 | 2007-04-25 |
| 1740407584 | Thomas C Kirk Jr. | Chiropractor | 820 Ebenezer Church Rd, Suite 100, Sharpsburg, GA 30277-2073 | 2007-04-20 |
| 1689891483 | Humber-kirk Chiropractic Clinic, LLC | Chiropractor | 820 Ebenezer Church Rd, Suite 100, Sharpsburg, GA 30277-2073 | 2007-04-20 |
| 1841417631 | Humber-kirk Chiropractic Clinic, LLC | Chiropractor | 820 Ebenezer Church Rd, Suite 100, Sharpsburg, GA 30277-2073 | 2007-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295347433 | Joshua Su-keong Chao | Pharmacist | 40 Fischer Crossings Blvd, Sharpsburg, GA 30277 | 2020-08-19 |
| 1093375503 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 40 Fischer Crossings Dr, Sharpsburg, GA 30277 | 2019-06-17 |
| 1295395705 | Costco Wholesale Corporation | Hearing Aid Equipment | 40 Fischer Crossings Dr., Sharpsburg, GA 30277 | 2019-06-17 |
| 1154392744 | John Schuler | Family Medicine | 3345 E Hwy 34, Suite 101, Sharpsburg, GA 30277 | 2006-01-31 |
| 1083619233 | George Joseph Vellanikaran | Internal Medicine | 20 Francis Way, Suite 101, Sharpsburg, GA 30277 | 2005-06-15 |
| 1659931160 | Costco Wholesale Corporation | Pharmacy | 40 Fischer Crossings Dr., Sharpsburg, GA 30277 | 2019-06-17 |
| 1114379963 | Sherri Christopher | Marriage & Family Therapist | 4006 Highway 34 E, Sharpsburg, GA 30277 | 2016-07-05 |
| 1932533197 | Liberty Mcclead | Social Worker | 820 Ebenezer Church Rd Ste 110, Sharpsburg, GA 30277 | 2013-08-23 |
| 1326348079 | Sams East Inc | Technician/Technologist | 310 Fischer Rd, Peachtree City, GA 30277 | 2010-10-28 |
| 1689845950 | Cardiovascular Consultants of Georgia, P.C. | Internal Medicine | 20 Francis Way, Suite 101, Sharpsburg, GA 30277 | 2008-03-14 |
| Find all providers in zip 30277 | ||||
| Taxonomy Code | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477153492 | Legacy Hospice Ga | Hospice Care, Community Based | 1700 Frederica Rd Ste 205, St Simons Island, GA 31522-2583 | 2020-10-28 |
| 1013515030 | Perimeter Hospice of Georgia | Hospice Care, Community Based | 150 Stanley Ct Ste E, Lawrenceville, GA 30046-5215 | 2020-10-12 |
| 1780291039 | Goldencare Hospice and Palliative Care | Hospice Care, Community Based | 7555 Bridgegate Ct, Sandy Springs, GA 30350-4604 | 2020-09-29 |
| 1255947651 | Community Hospice of Georgia | Hospice Care, Community Based | 321 N Main St Ste A, Adairsville, GA 30103-2403 | 2020-09-21 |
| 1437762382 | Allaway Angels | Hospice Care, Community Based | 805 Deerfield Ct, Stone Mountain, GA 30087-5483 | 2020-08-28 |
| 1144832494 | Circle of Hope Hospice | Hospice Care, Community Based | 5750 Brook Hollow Pkwy Ste 105, Norcross, GA 30071-3515 | 2020-08-18 |
| 1518578335 | Jaslinks Hospice Inc | Hospice Care, Community Based | 2282 Meadow Church Rd Ste 300, Duluth, GA 30097-5318 | 2020-08-14 |
| 1104434570 | An Angels Touch Hospice LLC | Hospice Care, Community Based | 2345 4th St Ste 600d, Tucker, GA 30084-8518 | 2020-07-21 |
| 1609494327 | Divine Guardian LLC | Hospice Care, Community Based | 2321 4th St Ste 210, Tucker, GA 30084-8516 | 2020-07-09 |
| 1184242026 | Champions Nursing Services, LLC | Hospice Care, Community Based | 2365 Wall St Se Ste 210, Conyers, GA 30013-2197 | 2020-07-07 |
| Find all providers with the same taxonomy | ||||
| City | SHARPSBURG |
| Zip Code | 30277 |
Please comment or provide details below to improve the information on COUNTRYSIDE HOSPICE CARE INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.