1831289644 NPI number — PARAGON HOSPICE MANAGEMENT, LP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831289644 NPI number — PARAGON HOSPICE MANAGEMENT, LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PARAGON HOSPICE MANAGEMENT, 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:
Provider Other Organization Name Type Code:
6
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:
1831289644
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/01/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 SUGAR CREEK CENTER BLVD
Provider Second Line Business Mailing Address:
SUITE 330
Provider Business Mailing Address City Name:
SUGAR LAND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77478-3560
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-277-1151
Provider Business Mailing Address Fax Number:
281-277-1170

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
655 BRAWLEY SCHOOL RD
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
MOORESVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28117-9125
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-664-2876
Provider Business Practice Location Address Fax Number:
704-664-1306
Provider Enumeration Date:
10/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ABELL
Authorized Official First Name:
DOUG
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF COMPLIANCE OFFICER
Authorized Official Telephone Number:
704-664-2876

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)

  • Identifier: 67-1590 . This is a "MEDICARE MPN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 013945 . This is a "LICENSE" identifier . This identifiers is of the category "OTHER".




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