MEDICARE: RHI OF MIDDLE GEORGIA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HSPC001461	OTHER	GA	STATE OPERATORS LICENSE

General Provider Information

NPI Number	:	1134886609
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RHI OF MIDDLE GEORGIA LLC

Provider Business Mailing Address
First Line	:	101 W RENNER RD STE 420
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75082-2022
Country	:	US
Telephone Number	:	877-525-3338
Fax Number	:

Provider Business Practice Location Address
First Line	:	912 BELLEVUE AVE
Second Line	:
City	:	DUBLIN
State	:	GA
Zip	:	31021-4850
Country	:	US
Telephone Number	:	478-621-7380
Fax Number	:	478-246-0946

Authorized Official
Title or Position	:	EXECUTIVE VICE PRESIDENT/ COO
Name	:	DONNIE MABERRY
Credential	:
Telephone Number	:	806-587-0121

Provider Enumeration Date	:	11/19/2021
Last Update Date	:	04/15/2026

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