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General NPI Number Information
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NPI Number | 1720691017
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Entity Type | Organization
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Legal Business Name | GOOD SHEPHERD HOSPICE, INC.
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Dates
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Enumeration Date | 08/26/2020
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Last Update Date | 03/15/2021
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Provider Practice Location Address
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Address Line | 11400 OVERSEAS HWY STE 203
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City | MARATHON
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State | FL
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Zip | 33050-3600
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Country | US
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Telephone | 305-396-8100
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Fax |
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Provider Business Mailing Address
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Address Line | 12470 TELECOM DR STE 300W ATTN: LEGAL
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City | TEMPLE TERRACE
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State | FL
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Zip | 33637-0904
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Country | US
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Telephone | 813-871-8075
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Fax | 813-871-8076
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Authorized Official
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Title or Position | CHIEF COMPLIANCE OFFICER
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Name | SHARON PAMELA SAUCIER
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Credential |
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Telephone | 813-871-8031
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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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