Provider Demographics
NPI:1407432107
Name:TROPICAL HEALTH HOSPICE OF GEORGIA
Entity Type:Organization
Organization Name:TROPICAL HEALTH HOSPICE OF GEORGIA
Other - Org Name:TROPICAL HEALTH HOSPICE OF GEORGIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:678-448-2853
Mailing Address - Street 1:PO BOX 390551
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-0010
Mailing Address - Country:US
Mailing Address - Phone:470-226-1766
Mailing Address - Fax:470-226-1636
Practice Address - Street 1:2795 MAIN ST W STE 26A
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-3075
Practice Address - Country:US
Practice Address - Phone:470-427-2531
Practice Address - Fax:470-226-1636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-22
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAHSPC001451Medicaid