1710157987 NPI number — EVERCARE 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 1710157987 NPI number — EVERCARE HOSPICE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EVERCARE 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:
1710157987
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/04/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
680 BLAIR MILL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HORSHAM
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19044-2223
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-900-2824
Provider Business Mailing Address Fax Number:
215-902-8809

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2300 CLAYTON RD
Provider Second Line Business Practice Location Address:
SUITE 1000
Provider Business Practice Location Address City Name:
CONCORD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94520-2100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-437-4673
Provider Business Practice Location Address Fax Number:
925-602-2822
Provider Enumeration Date:
03/04/2008

Additional Information

Authorized Official

Authorized Official Last Name:
ENDERLE
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
O.
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
860-221-0793

Provider Taxonomy Codes

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

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





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