1447845185 NPI number — HERNANDO-PASCO HOSPICE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447845185 NPI number — HERNANDO-PASCO HOSPICE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HERNANDO-PASCO HOSPICE, 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:
Provider Other Organization Name Type Code:
6
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:
1447845185
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/04/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12470 TELECOM DRIVE, SUITE 301
Provider Second Line Business Mailing Address:
ATTENTION: COMPLIANCE
Provider Business Mailing Address City Name:
TEMPLE TERRACE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33637-0904
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-871-8075
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12254 CORTEZ BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKSVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34613-2626
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-616-0795
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/04/2021

Additional Information

Authorized Official

Authorized Official Last Name:
BUCCIARELLI
Authorized Official First Name:
CRYSTAL
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF LEGAL SERVICES
Authorized Official Telephone Number:
813-871-8075

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 299995071 . This is a "AGENCY FOR HEALTH CARE ADMINISTRATION" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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