Provider Demographics
NPI:1033278999
Name:MAHOGANY HOSPICE CARE, INC
Entity type:Organization
Organization Name:MAHOGANY HOSPICE CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:SUGGS
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:615-254-6345
Mailing Address - Street 1:1 VANTAGE WAY STE B125
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1530
Mailing Address - Country:US
Mailing Address - Phone:615-254-6345
Mailing Address - Fax:615-985-0013
Practice Address - Street 1:1 VANTAGE WAY STE B125
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37228-1530
Practice Address - Country:US
Practice Address - Phone:615-254-6345
Practice Address - Fax:615-985-0013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN441592251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4044636OtherTENNCARE SELECT HOSPICE
TN441592Medicare ID - Type UnspecifiedHOSPICE