Provider Demographics
NPI:1437392800
Name:DOCTORS HOSPICE OF GEORGIA, INC
Entity Type:Organization
Organization Name:DOCTORS HOSPICE OF GEORGIA, INC
Other - Org Name:DOCTORS HOSPICE OF GEORGIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MCHUGH
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:706-307-1400
Mailing Address - Street 1:3660 HOWELL FERRY RD
Mailing Address - Street 2:BUILDING B
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-3178
Mailing Address - Country:US
Mailing Address - Phone:706-307-1400
Mailing Address - Fax:770-586-5081
Practice Address - Street 1:3660 HOWELL FERRY RD
Practice Address - Street 2:BUILDING B
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-3178
Practice Address - Country:US
Practice Address - Phone:706-307-1400
Practice Address - Fax:770-586-5081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA067-0316-HOtherSTATE OF GEORGIA