Provider Demographics
NPI:1548678923
Name:SOVEREIGN HOSPICE INC.
Entity type:Organization
Organization Name:SOVEREIGN HOSPICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ENID
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:RN CHPN
Authorized Official - Phone:770-687-1232
Mailing Address - Street 1:5675 JIMMY CARTER BLVD STE 100B
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30071-4666
Mailing Address - Country:US
Mailing Address - Phone:470-223-3773
Mailing Address - Fax:404-991-3662
Practice Address - Street 1:5675 JIMMY CARTER BLVD STE 100B
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-4666
Practice Address - Country:US
Practice Address - Phone:470-223-3773
Practice Address - Fax:404-991-3662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based