Organization
BRISTOL HOSPICE - GEORGIA LLC
Active
Parent organization
BRISTOL HOSPICE, L.L.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
BRISTOL HOSPICE, L.L.C.
Authorized official
ALEX MAURICIO (PRESIDENT/CEO)
(801) 325-0175
Entity
Organization
Contact information
Practice address
2849 PACES FERRY RD SE STE 380, ATLANTA, GA 30339-3769
(770) 434-9530
(770) 434-9529
Mailing address
206 N 2100 W STE 202, SALT LAKE CITY, UT 84116-4741
(801) 325-0175
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003119387A
—
GA
Enumeration date
11/18/2010
Last updated
09/26/2023
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