Provider Demographics
NPI:1720691017
Name:GOOD SHEPHERD HOSPICE, INC.
Entity Type:Organization
Organization Name:GOOD SHEPHERD HOSPICE, INC.
Other - Org Name:CHAPTERS HEALTH HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:PAMELA
Authorized Official - Last Name:SAUCIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-871-8031
Mailing Address - Street 1:12470 TELECOM DR STE 300W
Mailing Address - Street 2:ATTN: LEGAL
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-0904
Mailing Address - Country:US
Mailing Address - Phone:813-871-8075
Mailing Address - Fax:813-871-8076
Practice Address - Street 1:11400 OVERSEAS HWY STE 203
Practice Address - Street 2:
Practice Address - City:MARATHON
Practice Address - State:FL
Practice Address - Zip Code:33050-3600
Practice Address - Country:US
Practice Address - Phone:305-396-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOOD SHEPHERD HOSPICE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-26
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based