1447472006 NPI number — OPTUM PALLIATIVE AND HOSPICE CARE OF PENNSYLVANIA, INC.

Table of content: (NPI 1447472006)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447472006 NPI number — OPTUM PALLIATIVE AND HOSPICE CARE OF PENNSYLVANIA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OPTUM PALLIATIVE AND HOSPICE CARE OF PENNSYLVANIA, 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 INSPIRIS OF PENNSYLVANIA, INC.
Provider Other Organization Name Type Code:
5
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:
1447472006
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/25/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1009 WINDCROSS CT
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
FRANKLIN
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37067
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-224-5440
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 AMERICAN AVENUE
Provider Second Line Business Practice Location Address:
SUITE 206
Provider Business Practice Location Address City Name:
KING OF PRUSSIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19406
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-265-2006
Provider Business Practice Location Address Fax Number:
610-265-2766
Provider Enumeration Date:
05/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ENDERLE
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
860-616-7221

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251G00000X , with the licence number: 16951601 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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