MEDICARE: ATL HOSPICE AND PALLIATIVE CARE 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	:	1487388419
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATL HOSPICE AND PALLIATIVE CARE LLC

Provider Business Mailing Address
First Line	:	4482 COMMERCE DR STE 113
Second Line	:
City	:	BUFORD
State	:	GA
Zip	:	30518-7509
Country	:	US
Telephone Number	:	470-592-0440
Fax Number	:

Provider Business Practice Location Address
First Line	:	2450 ATLANTA HWY STE 1202
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30040-1253
Country	:	US
Telephone Number	:	470-592-0440
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	ANITA PRINCE
Credential	:	NP
Telephone Number	:	678-353-8528

Provider Enumeration Date	:	07/14/2022
Last Update Date	:	12/01/2025

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