Basic Information
Provider Information
NPI: 1922397280
EntityType: 2
ReplacementNPI:  
OrganizationName: ENVOY HOSPICE, LLC
LastName:  
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Mailing Information
Address1: 500 FAULCONER DR STE 200
Address2:  
City: CHARLOTTESVILLE
State: VA
PostalCode: 229035089
CountryCode: US
TelephoneNumber: 4349779711
FaxNumber: 4349779715
Practice Location
Address1: 1412 W MAGNOLIA AVE STE 100
Address2:  
City: FORT WORTH
State: TX
PostalCode: 76104
CountryCode: US
TelephoneNumber: 8172893990
FaxNumber: 8172893995
Other Information
ProviderEnumerationDate: 04/06/2011
LastUpdateDate: 01/09/2020
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: HUNTER
AuthorizedOfficialFirstName: JOHN
AuthorizedOfficialMiddleName: B.
AuthorizedOfficialTitleorPosition: PRESIDENT & CEO
AuthorizedOfficialTelephone: 4349779711
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 01/09/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251G00000X  Y AgenciesHospice Care, Community Based 

No ID Information.


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