MEDICARE: HASLUP HOSPICE ENTERPRISES, LTD

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician
2	251G00000X	Community Based Hospice Care Agency		VA

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1073530846	OTHER	VA	NPI
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	1225068190	OTHER	VA	NPI
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1932401494
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HASLUP HOSPICE ENTERPRISES, LTD

Provider Business Mailing Address
First Line	:	103 S PANTOPS DR
Second Line	:	SUITE 205
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22911-8617
Country	:	US
Telephone Number	:	434-295-5501
Fax Number	:	434-295-4938

Provider Business Practice Location Address
First Line	:	516 S INDEPENDENCE BLVD STE 106
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-1153
Country	:	US
Telephone Number	:	757-466-1401
Fax Number	:	757-466-8223

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAVID N. HASLUP
Credential	:
Telephone Number	:	434-295-5501

Provider Enumeration Date	:	12/03/2010
Last Update Date	:	03/22/2023

516 S INDEPENDENCE BLVD , SUITE 106
VIRGINIA BEACH, VA
23452-1153

Practice Phone: 757-466-1401
Practice Fax: 757-466-8223