MEDICARE: THI OF TEXAS AT SAMARITAN HOSPICE, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician
2	363LF0000X	Family Nurse Practitioner
3	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician

General Provider Information

NPI Number	:	1144902982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THI OF TEXAS AT SAMARITAN HOSPICE, LLC

Provider Business Mailing Address
First Line	:	10 CADILLAC DR STE 400
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-1001
Country	:	US
Telephone Number	:	615-637-9163
Fax Number	:	615-373-4457

Provider Business Practice Location Address
First Line	:	510 N VALLEY MILLS DR STE 505
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76710-6078
Country	:	US
Telephone Number	:	254-870-5174
Fax Number	:	254-741-1509

Authorized Official
Title or Position	:	SVP, CHIEF LEGAL OFFICER
Name	:	RUSSELL ADKINS
Credential	:
Telephone Number	:	615-309-5668

Provider Enumeration Date	:	08/02/2023
Last Update Date	:	08/02/2023

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