1437435708 NPI number — NEW HOPE HOSPICE OF BULLHEAD CITY 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 1437435708 NPI number — NEW HOPE HOSPICE OF BULLHEAD CITY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW HOPE HOSPICE OF BULLHEAD CITY 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:
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:
1437435708
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/10/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2191 LEMAY FERRY RD STE. 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ST LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63125-2408
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-815-3500
Provider Business Mailing Address Fax Number:
314-815-3207

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3550 NORTH LANE, STE 102, 104, 106, 108
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BULLHEAD CITY
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86442-9114
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-444-8122
Provider Business Practice Location Address Fax Number:
928-444-8155
Provider Enumeration Date:
10/31/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SEELE
Authorized Official First Name:
TAMBERLY
Authorized Official Middle Name:
JEAN
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
315-815-3500

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  HSPC5120 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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