Provider Demographics
NPI:1851570782
Name:IMS HOSPICE
Entity Type:Organization
Organization Name:IMS HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEVUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-754-6339
Mailing Address - Street 1:2140 MCGEE RD # 340
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-2980
Mailing Address - Country:US
Mailing Address - Phone:678-360-2448
Mailing Address - Fax:
Practice Address - Street 1:3300 BUCKEYE RD STE 264
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341-4234
Practice Address - Country:US
Practice Address - Phone:404-299-3838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-27
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044-R-0116251E00000X, 251J00000X
GAR117235251F00000X
251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care