Healthcare Provider Details

I. General information

NPI: 1184608598
Provider Name (Legal Business Name): HOSPICE OF THE CHESAPEAKE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4559 SIXES RD
PRINCE FREDERICK MD
20678-5739
US

IV. Provider business mailing address

4559 SIXES RD
PRINCE FREDERICK MD
20678-5739
US

V. Phone/Fax

Practice location:
  • Phone: 443-837-1519
  • Fax:
Mailing address:
  • Phone: 410-535-0892
  • Fax: 410-535-5677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberH1521
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code251T00000X
TaxonomyPACE Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: GERALD MICHAEL HILL
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 667-210-9253