Provider Demographics
NPI:1609811009
Name:HOSPICE AND PALLIATIVE PHYSICIAN SERVICES, LLC
Entity type:Organization
Organization Name:HOSPICE AND PALLIATIVE PHYSICIAN SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCGREW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-650-2250
Mailing Address - Street 1:4644 KEYSVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-3515
Mailing Address - Country:US
Mailing Address - Phone:352-650-2250
Mailing Address - Fax:352-666-4216
Practice Address - Street 1:4644 KEYSVILLE AVE
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-3515
Practice Address - Country:US
Practice Address - Phone:352-650-2250
Practice Address - Fax:352-666-4216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2046Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER