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General NPI Number Information
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NPI Number | 1760440424
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Entity Type | Organization
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Legal Business Name | REGENCY HOSPICE OF GEORGIA, LLC
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 05/23/2023
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Provider Practice Location Address
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Address Line | 2924 PROFESSIONAL PKWY SUITE A
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City | AUGUSTA
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State | GA
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Zip | 30907-6529
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Country | US
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Telephone | 706-868-4422
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Fax | 706-868-4424
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Provider Business Mailing Address
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Address Line | PO BOX 4060
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City | MOORESVILLE
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State | NC
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Zip | 28117-4060
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Country | US
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Telephone | 704-644-2876
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Fax |
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Authorized Official
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Title or Position | VP OF LEGAL AFFAIRS
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Name | JANET COMBS
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Credential |
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Telephone | 913-814-2013
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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 | 111637
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License Number State | GA
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