Healthcare Provider Details

I. General information

NPI: 1568485894
Provider Name (Legal Business Name): CAPITAL HOSPICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3180 FAIRVIEW PARK DR STE 500
FALLS CHURCH VA
22042-4583
US

IV. Provider business mailing address

3180 FAIRVIEW PARK DR STE 500
FALLS CHURCH VA
22042-4583
US

V. Phone/Fax

Practice location:
  • Phone: 703-538-2065
  • Fax: 703-532-1054
Mailing address:
  • Phone: 703-538-2065
  • Fax: 703-532-1054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License NumberH1857
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberHSP-0617
License Number StateVA

VIII. Authorized Official

Name: CRYSTAL BUCCIARELLI
Title or Position: VP, LEGAL SERVICES
Credential:
Phone: 813-871-8075