MEDICARE: ODYSSEY HEALTHCARE OPERATING A LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency	080000767	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669451662
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ODYSSEY HEALTHCARE OPERATING A LP

Provider Business Mailing Address
First Line	:	717 N HARWOOD ST
Second Line	:	SUITE 1500
City	:	DALLAS
State	:	TX
Zip	:	75201-6519
Country	:	US
Telephone Number	:	214-922-9711
Fax Number	:	214-922-9752

Provider Business Practice Location Address
First Line	:	525 CABRILLO PARK DRIVE
Second Line	:	SUITE 150
City	:	SANTA ANA
State	:	CA
Zip	:	92701-5012
Country	:	US
Telephone Number	:	714-245-7420
Fax Number	:	714-245-7424

Authorized Official
Title or Position	:	SR VP & CFO
Name	:	MR. RODNEY DIRK ALLISON
Credential	:
Telephone Number	:	214-922-9711

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	03/31/2009

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