MEDICARE: LONGLEAF 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
2	251G00000X	Community Based Hospice Care Agency	0440301H	GA

General Provider Information

NPI Number	:	1427206960
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LONGLEAF HOSPICE, LLC

Provider Business Mailing Address
First Line	:	2310 PARKLAKE DR NE STE 325
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30345-2915
Country	:	US
Telephone Number	:	770-939-9179
Fax Number	:	770-621-3083

Provider Business Practice Location Address
First Line	:	2310 PARKLAKE DR NE STE 325
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30345-2915
Country	:	US
Telephone Number	:	770-939-9179
Fax Number	:	770-621-3083

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. EDWARD PHILLIP STONE
Credential	:
Telephone Number	:	770-939-9179

Provider Enumeration Date	:	09/08/2008
Last Update Date	:	12/01/2024

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Directions to “LONGLEAF HOSPICE, LLC ” Practice Location

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