Healthcare Provider Details

I. General information

NPI: 1942755665
Provider Name (Legal Business Name): HOSPICE ADVANTAGE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2016
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7535 WINDSOR DR STE B100
ALLENTOWN PA
18106-8810
US

IV. Provider business mailing address

10 CADILLAC DR SUITE 400
BRENTWOOD TN
37027-5078
US

V. Phone/Fax

Practice location:
  • Phone: 610-336-8000
  • Fax: 610-336-8001
Mailing address:
  • Phone: 417-841-4834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086H0002X
TaxonomyHospice and Palliative Medicine (Surgery) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: RUSSELL ADKINS
Title or Position: SVP GENERAL COUNSEL
Credential:
Phone: 615-926-0340