Provider Demographics
NPI:1871694133
Name:PRIORITY HOSPICE CARE, INC
Entity type:Organization
Organization Name:PRIORITY HOSPICE CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-360-1238
Mailing Address - Street 1:619 WOODLAND ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206-4211
Mailing Address - Country:US
Mailing Address - Phone:615-228-1161
Mailing Address - Fax:615-242-6427
Practice Address - Street 1:619 WOODLAND ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37206-4211
Practice Address - Country:US
Practice Address - Phone:615-228-1161
Practice Address - Fax:615-242-6427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000326251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3135379OtherTENNCARE PROVIDER NUMBER
TN01041745OtherAMERIGROUP COMMUNITY CARE
TN441532Medicare ID - Type UnspecifiedPROVIDER NUMBER
TN441532Medicare Oscar/Certification