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General NPI Number Information
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NPI Number | 1205183878
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Entity Type | Organization
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Legal Business Name | ODYSSEY HEALTHCARE OPERATING B, LP
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Dates
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Enumeration Date | 08/13/2012
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Last Update Date | 01/17/2024
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Provider Practice Location Address
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Address Line | 1326 N WHITMAN LN
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City | LIBERTY LAKE
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State | WA
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Zip | 99019-7594
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Country | US
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Telephone | 509-789-4377
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Fax | 509-755-4962
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Provider Business Mailing Address
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Address Line | 655 BRAWLEY SCHOOL RD STE 200
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City | MOORESVILLE
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State | NC
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Zip | 28117-9601
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Country | US
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Telephone | 704-664-2876
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Fax | 704-664-1306
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Authorized Official
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Title or Position | VP OF LICENSURE
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Name | JANET COMBS
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Credential |
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Telephone | 704-664-1306
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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 | IHS.FS.00000472
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License Number State | WA
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