Provider Demographics
NPI:1740263557
Name:METROPOLITAN HOSPICE
Entity type:Organization
Organization Name:METROPOLITAN HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SOUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BADII
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-988-0880
Mailing Address - Street 1:200 VILLAGE PKWY NE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-4062
Mailing Address - Country:US
Mailing Address - Phone:770-988-0880
Mailing Address - Fax:
Practice Address - Street 1:200 VILLAGE PKWY NE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-4062
Practice Address - Country:US
Practice Address - Phone:770-988-0880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033-230H251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA51004926-001OtherBLUE CROSS
GA111598Medicare Oscar/Certification