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NPI 1235270505

NPI 1235270505 : ODYSSEY HEALTHCARE OF AUGUSTA, LLC : AUGUSTA, GA

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General NPI Number Information
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    NPI Number           |    1235270505
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    Entity Type          |    Organization 
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    Legal Business Name  |    ODYSSEY HEALTHCARE OF AUGUSTA, LLC 
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Dates
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    Enumeration Date     |    02/09/2007
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    Last Update Date     |    01/17/2023
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Provider Practice Location Address
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    Address Line         |    3508 PROFESSIONAL CIR STE A 
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    City                 |    AUGUSTA
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    State                |    GA
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    Zip                  |    30907-8232
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    Country              |    US
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    Telephone            |    706-210-5900
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    Fax                  |    706-228-1601
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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                 |    MS. JANET  COMBS 
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    Credential           |    
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    Telephone            |    704-662-1761
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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       |    
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    License Number State |    
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