Healthcare Provider Details

I. General information

NPI: 1598466138
Provider Name (Legal Business Name): ODYSSEY HEALTHCARE OPERATING A, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2023
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1718 INDIAN WOOD CIR STE A
MAUMEE OH
43537-4090
US

IV. Provider business mailing address

PO BOX 4060
MOORESVILLE NC
28117-4060
US

V. Phone/Fax

Practice location:
  • Phone: 419-824-7400
  • Fax: 567-408-7506
Mailing address:
  • Phone: 704-664-2876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JANET COMBS
Title or Position: VP OF LICENSURE
Credential:
Phone: 704-664-2876