MEDICARE: COSMOS HOSPICE 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

General Provider Information

NPI Number	:	1235397407
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COSMOS HOSPICE LLC

Provider Business Mailing Address
First Line	:	717 N HARWOOD ST
Second Line	:	SUITE 570
City	:	DALLAS
State	:	TX
Zip	:	75201-6501
Country	:	US
Telephone Number	:	214-217-1105
Fax Number	:	214-382-4440

Provider Business Practice Location Address
First Line	:	717 N HARWOOD ST
Second Line	:	SUITE 570
City	:	DALLAS
State	:	TX
Zip	:	75201-6501
Country	:	US
Telephone Number	:	214-217-1105
Fax Number	:	214-382-4440

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	BOB SARNA
Credential	:
Telephone Number	:	214-217-1105

Provider Enumeration Date	:	05/23/2008
Last Update Date	:	04/07/2011

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Directions to “COSMOS HOSPICE LLC ” Practice Location

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