Healthcare Provider Details

I. General information

NPI: 1609733583
Provider Name (Legal Business Name): BOSE HOSPICE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 E MAIN ST STE A1B-215
BUFORD GA
30518-5727
US

IV. Provider business mailing address

115 E MAIN ST STE A1B-215
BUFORD GA
30518-5727
US

V. Phone/Fax

Practice location:
  • Phone: 470-331-6622
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: BOSE DELE
Title or Position: DIRECTOR
Credential:
Phone: 470-331-6622