Provider Demographics
NPI:1760763510
Name:HOSPICE ADVANTAGE, LLC.
Entity Type:Organization
Organization Name:HOSPICE ADVANTAGE, LLC.
Other - Org Name:COMPASSUS - MEMPHIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-309-5668
Mailing Address - Street 1:10 CADILLAC DR STE 400
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-1001
Mailing Address - Country:US
Mailing Address - Phone:615-377-7022
Mailing Address - Fax:615-373-4457
Practice Address - Street 1:1755 LYNNFIELD ST STE 108
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-7212
Practice Address - Country:US
Practice Address - Phone:901-309-1855
Practice Address - Fax:901-380-3685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-07
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN000000601251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN441579Medicare Oscar/Certification