Provider Demographics
NPI:1265433247
Name:ODYSSEY HEALTHCARE OPERATING A LP
Entity type:Organization
Organization Name:ODYSSEY HEALTHCARE OPERATING A LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF LICENSURE
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:COMBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-664-2876
Mailing Address - Street 1:655 BRAWLEY SCHOOL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-9601
Mailing Address - Country:US
Mailing Address - Phone:704-664-2876
Mailing Address - Fax:704-664-1306
Practice Address - Street 1:444 REGENCY PARKWAY DR
Practice Address - Street 2:SUITE 200
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3779
Practice Address - Country:US
Practice Address - Phone:402-397-0990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025019800Medicaid
NE10025196100Medicaid
NE10025293100Medicaid
NE10025142800Medicaid
IA0610261Medicaid
NE10025019700Medicaid
NE10025032900Medicaid
NE10025077800Medicaid
NE10025020100Medicaid
NE10025033000Medicaid
NE10025819100Medicaid
NE10025420500Medicaid
NE10025019500Medicaid
NE10025158100Medicaid
NE10025212000Medicaid
NE10025233000Medicaid
NE10025448900Medicaid
NE10025020000Medicaid
NE10025158200Medicaid
NE10025272200Medicaid
NE10025019900Medicaid
NE10025272300Medicaid