Healthcare Provider Details

I. General information

NPI: 1851570782
Provider Name (Legal Business Name): IMS HOSPICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2007
Last Update Date: 01/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 BUCKEYE RD STE 264
ATLANTA GA
30341-4234
US

IV. Provider business mailing address

2140 MCGEE RD # 340
SNELLVILLE GA
30078-2980
US

V. Phone/Fax

Practice location:
  • Phone: 404-299-3838
  • Fax:
Mailing address:
  • Phone: 678-360-2448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number044-R-0116
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License NumberR117235
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number044-R-0116
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. MAUREEN ASHE
Title or Position: EXEVUTIVE DIRECTOR
Credential:
Phone: 678-754-6339