Provider Demographics
NPI:1952302846
Name:ODYSSEY HEALTHCARE OPERATING A LP
Entity Type:Organization
Organization Name:ODYSSEY HEALTHCARE OPERATING A LP
Other - Org Name:ODYSSEY HEALTHCARE OF PHILADELPHIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VP & CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:DIRK
Authorized Official - Last Name:ALLISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-922-9711
Mailing Address - Street 1:717 N HARWOOD ST
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-6519
Mailing Address - Country:US
Mailing Address - Phone:214-922-9711
Mailing Address - Fax:214-922-9752
Practice Address - Street 1:512 TOWNSHIP LINE RD
Practice Address - Street 2:BUILDING 2 VALLEY SQUARE SUITE 305
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-2700
Practice Address - Country:US
Practice Address - Phone:215-619-7710
Practice Address - Fax:215-619-7740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA16461601251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019101900005Medicaid
391646Medicare Oscar/Certification