Provider Demographics
NPI:1891128658
Name:PALLADIUM HOSPICE AND PALLIATIVE CARE, LLC
Entity Type:Organization
Organization Name:PALLADIUM HOSPICE AND PALLIATIVE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAWN-MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:TEACHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-767-4837
Mailing Address - Street 1:3473 LAWRENCEVILLE SUWANEE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-7473
Mailing Address - Country:US
Mailing Address - Phone:770-715-9654
Mailing Address - Fax:864-214-7054
Practice Address - Street 1:3473 LAWRENCEVILLE SUWANEE RD
Practice Address - Street 2:SUITE C
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-7473
Practice Address - Country:US
Practice Address - Phone:770-715-9654
Practice Address - Fax:864-214-7054
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORIANNA INVESTMENT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-15
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based