MEDICARE: EMBRACING HOSPICECARE, 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	044162H	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336163815
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMBRACING HOSPICECARE, LLC

Provider Business Mailing Address
First Line	:	50 N LAURA ST
Second Line	:	STE 1800
City	:	JACKSONVILLE
State	:	FL
Zip	:	32202-3664
Country	:	US
Telephone Number	:	904-493-6745
Fax Number	:	904-262-4804

Provider Business Practice Location Address
First Line	:	5775 PEACHTREE DUNWOODY RD NE
Second Line	:	STE D 580
City	:	ATLANTA
State	:	GA
Zip	:	30342-1556
Country	:	US
Telephone Number	:	404-659-0110
Fax Number	:	770-454-7730

Authorized Official
Title or Position	:	CFO
Name	:	MR. RICH FOGLE
Credential	:
Telephone Number	:	904-493-6745

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	02/05/2010

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