Basic Information
| Provider Information | |||||||||
| NPI: | 1669829511 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HOSPICE PARTNERS OF AMERICA HOLDING, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | HOSPICE OF VIRGINIA | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3021 LORNA RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352164587 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2055337215 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2235 STAPLES MILL RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | RICHMOND | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232302942 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8042810451 | ||||||||
| FaxNumber: | 8042810954 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2016 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | STERN | ||||||||
| AuthorizedOfficialFirstName: | DEBORAH | ||||||||
| AuthorizedOfficialMiddleName: | H | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 2055338476 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251G00000X | EXEMPT | VA | Y | Agencies | Hospice Care, Community Based |
ID Information
| ID | Type | State | Issuer | Description | 1821747661 | 05 | VA | MEDICAID |