Provider Demographics
NPI:1255937322
Name:AVIDCARE HOSPICE 3 LLC
Entity type:Organization
Organization Name:AVIDCARE HOSPICE 3 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:SCURLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-424-2843
Mailing Address - Street 1:12808 W AIRPORT BLVD STE 292
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-6244
Mailing Address - Country:US
Mailing Address - Phone:844-424-2843
Mailing Address - Fax:
Practice Address - Street 1:12808 W AIRPORT BLVD STE 292
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-6244
Practice Address - Country:US
Practice Address - Phone:844-424-2843
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-04
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based