Provider Demographics
NPI:1558977942
Name:ODYSSEY HEALTHCARE OPERATING A LP
Entity Type:Organization
Organization Name:ODYSSEY HEALTHCARE OPERATING A LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF REGULATORY & LIC SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:PATIENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-662-0416
Mailing Address - Street 1:PO BOX 4060
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-4060
Mailing Address - Country:US
Mailing Address - Phone:704-664-0416
Mailing Address - Fax:704-664-1306
Practice Address - Street 1:4120 DUBLIN BLVD STE 105
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-7759
Practice Address - Country:US
Practice Address - Phone:925-737-0203
Practice Address - Fax:925-737-0245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No251G00000XAgenciesHospice Care, Community BasedGroup - Multi-Specialty