Healthcare Provider Details

I. General information

NPI: 1932937117
Provider Name (Legal Business Name): ODYSSEY HEALTHCARE OPERATING A LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2024
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 VALLEY RIVER DR STE 120
EUGENE OR
97401-2130
US

IV. Provider business mailing address

PO BOX 4060
MOORESVILLE NC
28117-4060
US

V. Phone/Fax

Practice location:
  • Phone: 541-359-4738
  • Fax: 541-255-2626
Mailing address:
  • Phone: 704-664-2876
  • Fax: 704-230-0946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

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