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NPI Code Detail

MEDICARE: DOCTORS HOSPICE OF GEORGIA, INC

MEDICARE: DOCTORS HOSPICE OF GEORGIA, 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 Agency067-3705-HGA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1067-3705-HOTHERGASTATE OF GEORGIA

General Provider Information

NPI Number : 1487897674
Entity Type Code : Organization
Provider Name (Legal Business Name) : DOCTORS HOSPICE OF GEORGIA, INC
Provider Business Mailing Address
First Line : 3660 HOWELL FERRY RD
Second Line : BUILDING B
City : DULUTH
State : GA
Zip : 30096-3178
Country : US
Telephone Number : 706-307-1400
Fax Number : 770-586-5108
Provider Business Practice Location Address
First Line : 1008 HIGHWAY 54
Second Line :
City : FAYETTEVILLE
State : GA
Zip : 30215-0000
Country : US
Telephone Number : 706-307-1400
Fax Number : 770-538-5108
Authorized Official
Title or Position : PRESIDENT
Name : KEVIN JOSEPH MCHUGH
Credential : RN, MSN
Telephone Number : 706-307-1400
Provider Enumeration Date : 04/17/2009
Last Update Date : 04/17/2009

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Directions to “DOCTORS HOSPICE OF GEORGIA, INC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.