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General NPI Number Information
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NPI Number | 1013402353
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Entity Type | Organization
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Legal Business Name | HOSPICE SERVICES OF GA, LLC
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Dates
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Enumeration Date | 06/28/2018
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Last Update Date | 02/20/2024
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Provider Practice Location Address
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Address Line | 3744 WALTON WAY EXT STE C
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City | AUGUSTA
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State | GA
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Zip | 30907-0917
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Country | US
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Telephone | 706-364-1933
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Fax | 706-364-1933
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Provider Business Mailing Address
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Address Line | 3744 WALTON WAY EXT STE C
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City | AUGUSTA
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State | GA
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Zip | 30907-0917
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Country | US
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Telephone | 706-364-1933
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Fax | 706-364-1933
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | CHRISTOPHER DAVID RUD
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Credential |
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Telephone | 706-834-8196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 121-0453-H
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License Number State | GA
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