- Enrollment id
- O20181026001740
- Enrollment state
- TX
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1265924294
- Multiple npi flag
- N
- Ccn
- 741799
- Associate id
- 1951654680
- Organization name
- AMEDICUS HOSPICE INC
- Incorporation date
- 2018-05-31
- Incorporation state
- TX
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 10935 ESTATE LN
- Address line 2
- STE 320
- City
- DALLAS
- State
- TX
- Zip code
- 752382355