BRISTOL HOSPICE - GEORGIA LLC NPI 1558663872

NPI Information

  • NPI: 1558663872
  • Provider Name: BRISTOL HOSPICE - GEORGIA LLC
  • Classification: Hospice Care, Community Based - 251G00000X
  • Entity Type: Organization
  • CLIA Number: 11D2021180
  • Address: 2849 PACES FERRY RD SE STE 380
    ATLANTA, GA
    ZIP 30339
  • Phone: (770) 434-9530

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NPI Details

BRISTOL HOSPICE - GEORGIA LLC is a hospice care community based in Atlanta, GA. BRISTOL HOSPICE - GEORGIA LLC NPI is 1558663872. The provider is registered as an organization entity type.

The provider's business location address is:

2849 PACES FERRY RD SE STE 380
ATLANTA, GA
ZIP 30339-769
Phone: (770) 434-9530
Fax: (770) 434-9529

The provider's authorized official is Alex Mauricio .
The authorized official title is President/ceo and has the following contact phone number (801) 325-0175.

The CLIA number assigned to this NPI record is 11D2021180 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/18/2010 and was last updated on 9/26/2023.

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
1251G00000XHospice Care, Community BasedYes

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
1003119387AMEDICAIDGEORGIA

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: 11/21/2025

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