Southern Companions, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

069-R-0635 Issued in GA

Legal business name

SOUTHERN COMPANIONS, LLC

Practice address

623 Green St NW
Suite B
Gainesville, GA 30501-3381

Phone

(678) 971-4147

Fax

(770) 825-9221

NPI assigned

Feb 3, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Allen Mack Jernigan Jr.

Title

Co-Owners

Phone

(678) 971-4147

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1486080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486080000000",
    "number": "1891233474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1082",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305031082",
            "telephone_number": "678-971-4147",
            "fax_number": "770-825-9221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 GREEN ST NW",
            "address_2": "SUITE B",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013381",
            "telephone_number": "678-971-4147",
            "fax_number": "770-825-9221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN COMPANIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-03",
        "last_updated": "2017-02-03",
        "status": "A",
        "authorized_official_last_name": "JERNIGAN",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_middle_name": "MACK",
        "authorized_official_title_or_position": "CO-OWNERS",
        "authorized_official_telephone_number": "678-971-4147",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "GA",
            "license": "069-R-0635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.