MEDICARE: ODYSSEY HEALTHCARE OPERATING A LP

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1558712885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ODYSSEY HEALTHCARE OPERATING A LP

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	:

Provider Business Practice Location Address
First Line	:	10800 FINANCIAL CENTRE PKWY STE 330
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72211-3544
Country	:	US
Telephone Number	:	501-508-8158
Fax Number	:	501-244-9107

Authorized Official
Title or Position	:	VP LICENSURE / AUTHORIZED OFFICIAL
Name	:	JANET L. COMBS
Credential	:
Telephone Number	:	704-664-2876

Provider Enumeration Date	:	06/28/2016
Last Update Date	:	11/26/2024

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