Provider Demographics
NPI:1912658774
Name:HPA MEDICAL MANAGEMENT, LLC
Entity Type:Organization
Organization Name:HPA MEDICAL MANAGEMENT, LLC
Other - Org Name:HOSPICE OF VIRGINIA SUPPORTIVE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & COO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BRADLEY
Authorized Official - Last Name:BICKHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-535-8200
Mailing Address - Street 1:6303 COWBOYS WAY STE 600
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-0329
Mailing Address - Country:US
Mailing Address - Phone:469-535-8200
Mailing Address - Fax:205-379-6720
Practice Address - Street 1:2235 STAPLES MILL RD STE 100
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-2942
Practice Address - Country:US
Practice Address - Phone:804-220-8842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADDUS HEALTHCARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-13
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty