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NPI Code Detail

MEDICARE: EH HOSPICE OF THE MID ATLANTIC, LLC

MEDICARE: EH HOSPICE OF THE MID ATLANTIC, 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
1251G00000XCommunity Based Hospice Care Agency

General Provider Information

NPI Number : 1295511624
Entity Type Code : Organization
Provider Name (Legal Business Name) : EH HOSPICE OF THE MID ATLANTIC, LLC
Provider Business Mailing Address
First Line : 6688 N CENTRAL EXPY STE 1300
Second Line :
City : DALLAS
State : TX
Zip : 75206-3950
Country : US
Telephone Number : 214-239-6500
Fax Number : 214-239-6581
Provider Business Practice Location Address
First Line : 5029 CORPORATE WOODS DR STE C110
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23462-4376
Country : US
Telephone Number : 757-938-3861
Fax Number : 757-401-6207
Authorized Official
Title or Position : EVP OF HOME HEALTH OPERATIONS
Name : JULIE D JOLLEY
Credential :
Telephone Number : 214-239-6500
Provider Enumeration Date : 09/01/2023
Last Update Date : 09/01/2023

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Directions to “EH HOSPICE OF THE MID ATLANTIC, LLC ” Practice Location

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