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  • 111769
CCN: 111769 NPI: 1144600875 Organization

SOUTHEAST HOSPICE

1203 GEORGE C. WILSON DRIVE SUITE A
AUGUSTA, GA 309094502

Contact Information

  • Phone 7063643108
  • Fax 7063643315
  • Enumeration Date 2015-06-08
  • Last Updated 2017-02-10

Taxonomies

  • Code: 251G00000X (Primary) License State: GA License: 121-0416-H

Inpatient Payment Attributes (IPSF) View Dictionary →

censusDivision 3
cbsaActualGeographicLocation 12260
providerType 35
censusDivision 3
cbsaActualGeographicLocation 12260
providerType 35
censusDivision 3
cbsaActualGeographicLocation 12260
providerType 35
censusDivision 3
cbsaActualGeographicLocation 12260
providerType 35
censusDivision 3
cbsaActualGeographicLocation 12260
providerType 35
censusDivision 3
cbsaActualGeographicLocation 12260
providerType 35

Outpatient Payment Attributes (OPSF) View Dictionary →

cbsaActualGeographicLocation 12260
providerType 35
specialPaymentIndicator
carrierCode 10212
localityCode 99
cbsaActualGeographicLocation 12260
providerType 35
specialPaymentIndicator
carrierCode 10212
localityCode 99

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