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General NPI Number Information
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NPI Number | 1730862764
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Entity Type | Organization
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Legal Business Name | EMPYREAN HOSPICE OF GEORGIA, LLC
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Dates
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Enumeration Date | 08/08/2023
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 1212 AUGUSTA WEST PKWY STE 201
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City | AUGUSTA
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State | GA
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Zip | 30909-1808
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Country | US
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Telephone | 706-842-7477
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Fax |
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Provider Business Mailing Address
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Address Line | 647 BRAWLEY SCHOOL RD STE 104
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City | MOORESVILLE
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State | NC
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Zip | 28117-6876
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CAO
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Name | STEPHANIE BAHETH
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Credential |
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Telephone | 980-920-3676
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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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