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NPI Code Detail

MEDICARE: LIFE CHOICE HOSPICE OF COLORADO II, LLC

MEDICARE: LIFE CHOICE HOSPICE OF COLORADO II, 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
1207RH0002XHospice and Palliative Medicine (Internal Medicine) Physician
2363LF0000XFamily Nurse Practitioner
3207QH0002XHospice and Palliative Medicine (Family Medicine) Physician

General Provider Information

NPI Number : 1174041214
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFE CHOICE HOSPICE OF COLORADO II, 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 : 615-377-7022
Fax Number : 615-373-4457
Provider Business Practice Location Address
First Line : 5475 TECH CENTER DR STE 105
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80919-2336
Country : US
Telephone Number : 719-226-0091
Fax Number : 719-226-7900
Authorized Official
Title or Position : SVP GENERAL COUNSEL
Name : RUSSELL ADKINS
Credential :
Telephone Number : 615-309-5668
Provider Enumeration Date : 09/08/2017
Last Update Date : 02/26/2019

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