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NPI Code Detail

MEDICARE: ALTUS HEALTHCARE AND HOSPICE INC

MEDICARE: ALTUS HEALTHCARE AND HOSPICE INC
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 Agency044-232-HGA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1044-232-HOTHERGAGA STATE LICENSE

General Provider Information

NPI Number : 1396880852
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALTUS HEALTHCARE AND HOSPICE INC
Provider Business Mailing Address
First Line : 1 DUNWOODY PARK
Second Line : SUITE 128
City : DUNWOODY
State : GA
Zip : 30338-7404
Country : US
Telephone Number : 770-730-8405
Fax Number : 770-730-8408
Provider Business Practice Location Address
First Line : 1 DUNWOODY PARK
Second Line : SUITE 128
City : DUNWOODY
State : GA
Zip : 30338-7404
Country : US
Telephone Number : 770-730-8405
Fax Number : 770-730-8408
Authorized Official
Title or Position : CEO CFO
Name : MR. DREW ANDERSON
Credential :
Telephone Number : 770-730-8405
Provider Enumeration Date : 02/21/2007
Last Update Date : 10/02/2007

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Directions to “ALTUS HEALTHCARE AND HOSPICE INC ” Practice Location

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