Healthcare Provider Details

I. General information

NPI: 1700885571
Provider Name (Legal Business Name): HOSPICE CARE OF THE EASTERN SHORE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18469 DUNNE AVE
PARKSLEY VA
23421-0316
US

IV. Provider business mailing address

PO BOX 316 18469 DUNNE AVE
PARKSLEY VA
23421-0316
US

V. Phone/Fax

Practice location:
  • Phone: 757-665-4895
  • Fax: 757-665-1171
Mailing address:
  • Phone: 757-665-4895
  • Fax: 757-665-1171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number05110-15
License Number StateVA

VIII. Authorized Official

Name: MS. LYNNE MARDAN LINDSAY
Title or Position: DIRECTOR OF ADMINISTRATIVE OPERATIO
Credential:
Phone: 757-665-4895