Healthcare Provider Details

I. General information

NPI: 1952913352
Provider Name (Legal Business Name): FMC PALLIATIVE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2020
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 LAKEVIEW DR
AMARILLO TX
79109-1531
US

IV. Provider business mailing address

2501 LAKEVIEW DR
AMARILLO TX
79109-1531
US

V. Phone/Fax

Practice location:
  • Phone: 806-355-8900
  • Fax: 806-355-2453
Mailing address:
  • Phone: 806-355-8900
  • Fax: 806-355-2453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVE SMITH
Title or Position: CEO
Credential:
Phone: 806-355-8900