Provider Demographics
NPI:1649914482
Name:MD HOSPICE LLC
Entity type:Organization
Organization Name:MD HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:GWEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-633-8620
Mailing Address - Street 1:5201 CONSTITUTION AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-5813
Mailing Address - Country:US
Mailing Address - Phone:505-910-4725
Mailing Address - Fax:505-872-0451
Practice Address - Street 1:5201 CONSTITUTION AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-5813
Practice Address - Country:US
Practice Address - Phone:505-910-4725
Practice Address - Fax:505-872-0451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based