OPTUM PALLIATIVE AND HOSPICE CARE INC. NPI 1487607040

NPI Information

NPI: 1487607040
Provider Name: OPTUM PALLIATIVE AND HOSPICE CARE, INC.

Former Legal Business Name: EVERCARE HOSPICE, INC.

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization
Address:
12018 SUNRISE VALLEY DRIVE, SUITE 401
RESTON, VA
ZIP 20191
Phone: (571) 262-5200
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OPTUM PALLIATIVE AND HOSPICE CARE, INC. is a hospice care community based in Reston, VA. OPTUM PALLIATIVE AND HOSPICE CARE, INC. NPI is 1487607040. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Evercare Hospice, Inc..

The provider's business location address is:

12018 SUNRISE VALLEY DRIVE, SUITE 401
RESTON, VA
ZIP 20191-434
Phone: (571) 262-5200
Fax: (571) 521-7249

The provider's authorized official is John O Enderle .
The authorized official title is President/ceo and has the following contact phone number (860) 221-0793.

The enumeration date for this NPI number is 5/17/2006 and was last updated on 11/4/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251G00000X	Hospice Care, Community Based		HSP-0625	VIRGINIA	No
2	251G00000X	Hospice Care, Community Based		HSP12137	VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	4910427	MEDICAID	VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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