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General NPI Number Information
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NPI Number | 1881540664
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Entity Type | Organization
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Legal Business Name | DIVINE HOSPICE AND PALLIATIVE CARE
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Dates
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Enumeration Date | 03/05/2026
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Last Update Date | 03/05/2026
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Provider Practice Location Address
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Address Line | 333 SWANSON DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-8536
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Country | US
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Telephone | 770-713-9399
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Fax |
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Provider Business Mailing Address
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Address Line | 333 SWANSON DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-8536
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Country | US
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Telephone | 770-713-9399
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DELROY ROPER
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Credential |
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Telephone | 770-713-9399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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