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General NPI Number Information
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NPI Number | 1982017620
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Entity Type | Organization
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Legal Business Name | ASTORIA HOSPICE
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Dates
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Enumeration Date | 06/10/2014
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Last Update Date | 06/10/2014
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Provider Practice Location Address
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Address Line | 50 HURT PLZ SE SUITE 520
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City | ATLANTA
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State | GA
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Zip | 30303-2946
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Country | US
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Telephone | 404-445-8505
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Fax | 404-445-8504
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Provider Business Mailing Address
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Address Line | 50 HURT PLZ SE SUITE 520
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City | ATLANTA
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State | GA
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Zip | 30303-2946
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Country | US
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Telephone | 404-445-8505
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DANDRE GREEN
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Credential |
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Telephone | 404-445-8505
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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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