Healthcare Provider Details

I. General information

NPI: 1033278999
Provider Name (Legal Business Name): MAHOGANY HOSPICE CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 VANTAGE WAY STE B125
NASHVILLE TN
37228-1530
US

IV. Provider business mailing address

1 VANTAGE WAY STE B125
NASHVILLE TN
37228-1530
US

V. Phone/Fax

Practice location:
  • Phone: 615-254-6345
  • Fax: 615-985-0013
Mailing address:
  • Phone: 615-254-6345
  • Fax: 615-985-0013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number441592
License Number StateTN

VIII. Authorized Official

Name: MR. TONY LOUIS SUGGS
Title or Position: OWNER
Credential: REGISTERED NURSE
Phone: 615-254-6345