1. Home
  2. Directory
  3. Georgia
  4. Hazlehurst
  5. Hospice Care Community Based
  6. NPI Profile

LEGACY HOSPICE OF SOUTH GA, LLC
NPI 1760204630
Hospice Care, Community Based in Hazlehurst, GA

Active since October 30, 2024CLIA 11D2314512 · Waiver
205 S TALLAHASSEE ST STE A, HAZLEHURST, GA 31539(912) 527-8602(912) 527-8671 Get Directions Write a Review

NPPES record last updated: May 12, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 12, 2026, Apr 15, 2026, Jun 12, 2025 and 1 more (4 updates tracked since 2024).

About Legacy Hospice Of South Ga, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEGACY HOSPICE OF SOUTH GA, LLC (NPI 1760204630), doing business as Coastal Hospice Of Georgia, is a healthcare organization registered as a hospice care, community based in Hazlehurst, Georgia and active in the NPI registry since October 2024. The organization holds a CLIA Waiver certificate valid through November 20, 2026 and lists Donnie Maberry, Executive Vice President, as its authorized official.

NPPES Registry Identity

NPI1760204630
Entity TypeOrganization
Primary Taxonomy251G00000X
Legal Business NameLEGACY HOSPICE OF SOUTH GA, LLC
Location Address205 S TALLAHASSEE ST STE AHazlehurst, GA 31539-6025
Mailing Address101 W Renner Rd Ste 420Richardson, TX 75082-2022 · (877) 525-3338
Phone(912) 527-8602
Fax(912) 527-8671
Organization SubpartNo
Authorized OfficialDonnie MaberryExecutive Vice President · (972) 468-8070
Enumeration DateOctober 30, 2024
Last NPPES UpdateMay 12, 20264 updates tracked since enumeration
NPPES CertifiedMay 12, 2026
✔ NPI 1760204630 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHospice Care, Community BasedAgencies
Taxonomy Code251G00000X
205 S TALLAHASSEE ST STE A, Hazlehurst, GA 31539
Open in Google Maps ↗

Other Names 1

Doing Business AsCoastal Hospice Of Georgia

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2314512

Legacy Hospice Of South Ga LLC Dba Coastal Hospice · Hazlehurst, GA
Active · expires Nov 20, 2026
CLIA Number11D2314512
Laboratory TypeHospice
Certificate Effective DateNovember 21, 2024
Certificate Expiration DateNovember 20, 2026
Laboratory DirectorElisha M. Allday
Laboratory Phone(912) 527-8602
Laboratory LocationLegacy Hospice Of South Ga LLC Dba Coastal Hospice205 S Tallahassee, Ste A, Hazlehurst, GA 31539
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Legacy Hospice Of South Ga, LLC's NPI number?

The NPI number for Legacy Hospice Of South Ga, LLC is 1760204630. It was assigned to this organization in the NPPES registry on October 30, 2024. The provider is doing business as Coastal Hospice of Georgia.

Where is Legacy Hospice Of South Ga, LLC located?

Legacy Hospice Of South Ga, LLC is located at 205 S Tallahassee St Ste A, Hazlehurst, GA 31539. The listed phone number is (912) 527-8602.

What is Legacy Hospice Of South Ga, LLC's specialty?

The primary specialty registered for this NPI is Hospice Care, Community Based with taxonomy code 251G00000X.

Does Legacy Hospice Of South Ga, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2314512) is associated with this NPI, valid through November 20, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Legacy Hospice Of South Ga, LLC was last updated on May 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.