Provider Demographics
NPI:1114254505
Name:TRANSITIONS HOSPICE CARE OF GEORGIA, INC.
Entity Type:Organization
Organization Name:TRANSITIONS HOSPICE CARE OF GEORGIA, INC.
Other - Org Name:TRANSITIONS HOSPICE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-377-2193
Mailing Address - Street 1:PO BOX 898
Mailing Address - Street 2:
Mailing Address - City:CASSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30123-0898
Mailing Address - Country:US
Mailing Address - Phone:470-377-2193
Mailing Address - Fax:855-913-1315
Practice Address - Street 1:1520 OLD TROLLEY RD STE 275
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-5292
Practice Address - Country:US
Practice Address - Phone:843-875-7915
Practice Address - Fax:843-875-7916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-06
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251G00000X
SCHPC0149251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCHSP130Medicaid
SCHPC0149OtherSTATE LICENSE
421602Medicare Oscar/Certification