Provider Demographics
NPI:1447590336
Name:PROFESSIONAL HOSPICE & PALLIATIVE CARE
Entity Type:Organization
Organization Name:PROFESSIONAL HOSPICE & PALLIATIVE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANISSA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:HEMINGWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-275-6185
Mailing Address - Street 1:2795 MAIN ST W STE 18A
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-3071
Mailing Address - Country:US
Mailing Address - Phone:470-275-6185
Mailing Address - Fax:470-275-6178
Practice Address - Street 1:2795 MAIN ST W STE 18A
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-3071
Practice Address - Country:US
Practice Address - Phone:470-275-6185
Practice Address - Fax:470-275-6178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-01
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based