1174652234 NPI number — ODYSSEY HEALTHCARE OPERATING B LP

Table of content: (NPI 1174652234)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174652234 NPI number — ODYSSEY HEALTHCARE OPERATING B LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ODYSSEY HEALTHCARE OPERATING B LP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ODYSSEY HEALTHCARE OF DAYTON
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174652234
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/17/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
717 N HARWOOD ST
Provider Second Line Business Mailing Address:
SUITE 1500 ATTN MICHELLE HARRIS
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75201-6519
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-922-9711
Provider Business Mailing Address Fax Number:
214-922-9752

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3085 WOODMAN DRIVE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
DAYTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45420-1193
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-922-9711
Provider Business Practice Location Address Fax Number:
214-922-9752
Provider Enumeration Date:
03/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ALLISON
Authorized Official First Name:
RODNEY
Authorized Official Middle Name:
DIRK
Authorized Official Title or Position:
SR VP & CFO
Authorized Official Telephone Number:
214-922-9711

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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