AZELEA HOSPICE NPI 1871109637

NPI Information

NPI: 1871109637
Provider Name: AZELEA HOSPICE
Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

CLIA Number: 11D2221244

Address:
1691 PHOENIX BLVD STE 170
ATLANTA, GA
ZIP 30349
Phone: (404) 806-9226
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AZELEA HOSPICE is a hospice care community based in Atlanta, GA. AZELEA HOSPICE NPI is 1871109637. The provider is registered as an organization entity type.

The provider's business location address is:

1691 PHOENIX BLVD STE 170
ATLANTA, GA
ZIP 30349-589
Phone: (404) 806-9226
Fax: (404) 393-4981

The provider's authorized official is Daniel Reshod Crumby .
The authorized official title is Administrator and has the following contact phone number (404) 806-9226.

The CLIA number assigned to this NPI record is 11D2221244 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/17/2020 and was last updated on 10/27/2023.

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
1	251G00000X	Hospice Care, Community Based				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	851554	OTHER	GEORGIA	PTAN

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: 4/28/2024

NPI Synchronization or Removal

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