1366444630 NPI number — HOSPICE CHOICE INC

Table of content: (NPI 1366444630)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366444630 NPI number — HOSPICE CHOICE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOSPICE CHOICE INC
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:
HOSPICE & PALLIATIVE CARE OF VIRGINIA
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:
1366444630
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/06/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 349
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24273-0349
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
276-679-7212
Provider Business Mailing Address Fax Number:
276-679-7245

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18 7TH ST NW
Provider Second Line Business Practice Location Address:
SUITE 302
Provider Business Practice Location Address City Name:
NORTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24273-1961
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
276-679-7212
Provider Business Practice Location Address Fax Number:
276-679-7245
Provider Enumeration Date:
06/01/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ADAMS
Authorized Official First Name:
SHERRY
Authorized Official Middle Name:
A
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
276-679-7212

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  0526-15 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 004910087 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 337550 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com