Provider Demographics
NPI:1407105018
Name:HARMONY HOSPICE LLC
Entity Type:Organization
Organization Name:HARMONY HOSPICE LLC
Other - Org Name:HARMONY HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:KUEHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-923-4677
Mailing Address - Street 1:110 HARMONY CROSSING
Mailing Address - Street 2:SUITE 1
Mailing Address - City:EATONTON
Mailing Address - State:GA
Mailing Address - Zip Code:31024-9553
Mailing Address - Country:US
Mailing Address - Phone:706-923-4677
Mailing Address - Fax:
Practice Address - Street 1:110 HARMONY CROSSING
Practice Address - Street 2:SUITE 1
Practice Address - City:EATONTON
Practice Address - State:GA
Practice Address - Zip Code:31024-9553
Practice Address - Country:US
Practice Address - Phone:706-923-4677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-29
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA117-0381-HMedicare PIN