1477823888 NPI number — MS. PATRICIA ANN GROFF HOSPICE CNA

Table of content: MS. PATRICIA ANN GROFF HOSPICE CNA (NPI 1477823888)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477823888 NPI number — MS. PATRICIA ANN GROFF HOSPICE CNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GROFF
Provider First Name:
PATRICIA
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
HOSPICE CNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
INTROCASO
Provider Other First Name:
PATRICIA
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1477823888
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/03/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 651
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FREDERICA
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19946
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-272-1734
Provider Business Mailing Address Fax Number:
302-335-8113

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3544 MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREDERICA
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19946
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-272-1734
Provider Business Practice Location Address Fax Number:
302-335-8113
Provider Enumeration Date:
01/03/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 376K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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