Healthcare Provider Details

I. General information

NPI: 1316909203
Provider Name (Legal Business Name): MONTGOMERY HOSPICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 KING FARM BLVD STE 400
ROCKVILLE MD
20850-5749
US

IV. Provider business mailing address

700 KING FARM BLVD STE 400
ROCKVILLE MD
20850-5749
US

V. Phone/Fax

Practice location:
  • Phone: 301-921-4400
  • Fax: 301-921-4433
Mailing address:
  • Phone: 301-921-4400
  • Fax: 301-921-4433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number211503
License Number StateMD

VIII. Authorized Official

Name: KAREN BRUBAKER MILLER
Title or Position: AUTHORIZED OFFICIAL, PRESIDENT/CEO
Credential:
Phone: 301-921-4400