Provider Demographics
NPI:1497052831
Name:UNIVERSITY HOSPICE, INC.
Entity type:Organization
Organization Name:UNIVERSITY HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HOSPICE
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:CAROLE
Authorized Official - Last Name:TERESHINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:706-828-2806
Mailing Address - Street 1:1350 WALTON WAY
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2612
Mailing Address - Country:US
Mailing Address - Phone:706-828-2806
Mailing Address - Fax:
Practice Address - Street 1:4106 COLUMBIA RD
Practice Address - Street 2:SUITE 201
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-1450
Practice Address - Country:US
Practice Address - Phone:706-868-3234
Practice Address - Fax:706-868-3235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-22
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based