Provider Demographics
NPI:1124171350
Name:LIFEPATH HOSPICE, INC.
Entity type:Organization
Organization Name:LIFEPATH HOSPICE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF COMPLIANCE & CLINICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:PAMELA
Authorized Official - Last Name:SAUCIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-871-8031
Mailing Address - Street 1:12470 TELECOM DR STE 300W
Mailing Address - Street 2:ATTENTION: COMPLIANCE
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-0904
Mailing Address - Country:US
Mailing Address - Phone:813-871-8400
Mailing Address - Fax:813-871-8402
Practice Address - Street 1:4200 W CYPRESS ST STE 690
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-4112
Practice Address - Country:US
Practice Address - Phone:813-877-2200
Practice Address - Fax:813-383-5041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5018095251G00000X, 251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL150022800Medicaid
FL101507Medicare Oscar/Certification