1942254537 NPI number — OPTUM PALLIATIVE AND HOSPICE CARE

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 1942254537 NPI number — OPTUM PALLIATIVE AND HOSPICE CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OPTUM PALLIATIVE AND HOSPICE CARE
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:
1942254537
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:
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:
713-219-6490
Provider Business Mailing Address Fax Number:
713-219-6491

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9702 BISSONNET ST
Provider Second Line Business Practice Location Address:
SUITE 2200W
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77036-8001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-219-6490
Provider Business Practice Location Address Fax Number:
713-219-6491
Provider Enumeration Date:
05/19/2006

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:
860-221-0793

Provider Taxonomy Codes

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





Copyright © 2007-2025 www.npivalidator.com