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General NPI Number Information
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NPI Number | 1912932948
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Entity Type | Organization
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Legal Business Name | HOSPICE OF THE PALM COAST INC
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 08/25/2009
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Provider Practice Location Address
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Address Line | 6161 BLUE LAGOON DRIVE SUITE 170
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City | MIAMI
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State | FL
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Zip | 33126-2045
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Country | US
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Telephone | 786-388-1400
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Fax | 786-388-1401
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Provider Business Mailing Address
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Address Line | 717 N HARWOOD ST SUITE 1500
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City | DALLAS
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State | TX
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Zip | 75201-6519
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Country | US
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Telephone | 214-922-9711
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Fax | 214-922-9752
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Authorized Official
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Title or Position | SR VP & CFO
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Name | MR. RODNEY DIRK ALLISON
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Credential |
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Telephone | 214-922-9711
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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 | 50370970
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License Number State | FL
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