1871898643 NPI number — ESTEEM HOSPICE, LLC

Table of content: (NPI 1871898643)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871898643 NPI number — ESTEEM HOSPICE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ESTEEM HOSPICE, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ESTEEM HOSPICE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871898643
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/12/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2459 E HEBRON PKWY
Provider Second Line Business Mailing Address:
STE 130
Provider Business Mailing Address City Name:
CARROLLTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75010-4482
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-239-8131
Provider Business Mailing Address Fax Number:
972-239-8183

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2459 E HEBRON PKWY
Provider Second Line Business Practice Location Address:
STE 130
Provider Business Practice Location Address City Name:
CARROLLTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75010-4482
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-239-8131
Provider Business Practice Location Address Fax Number:
972-239-8183
Provider Enumeration Date:
01/25/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MERCHANT
Authorized Official First Name:
GARY
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
972-239-8131

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)