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NPI Code Detail

MEDICARE: ODYSSEY HEALTHCARE OF MARION COUNTY, LLC

MEDICARE: ODYSSEY HEALTHCARE OF MARION COUNTY, 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
1251G00000XCommunity Based Hospice Care Agency

Other Identifiers

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

General Provider Information

NPI Number : 1528439700
Entity Type Code : Organization
Provider Name (Legal Business Name) : ODYSSEY HEALTHCARE OF MARION COUNTY, LLC
Provider Business Mailing Address
First Line : PO BOX 4060
Second Line :
City : MOORESVILLE
State : NC
Zip : 28117-4060
Country : US
Telephone Number : 704-664-2876
Fax Number : 704-664-1306
Provider Business Practice Location Address
First Line : 4776 NEW BROAD ST STE 200
Second Line :
City : ORLANDO
State : FL
Zip : 32814-6423
Country : US
Telephone Number : 407-514-1300
Fax Number : 407-514-1301
Authorized Official
Title or Position : VP LICENSURE
Name : JANET COMBS
Credential :
Telephone Number : 704-664-2876
Provider Enumeration Date : 10/13/2015
Last Update Date : 06/26/2025

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