1518167337 NPI number — PENNSYLVANIA TRINITY HOSPICE, LLC

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 1518167337 NPI number — PENNSYLVANIA TRINITY HOSPICE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PENNSYLVANIA TRINITY HOSPICE, LLC
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:
1518167337
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/19/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14180 DALLAS PKWY
Provider Second Line Business Mailing Address:
SUITE 800
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75254-4341
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-306-4520
Provider Business Mailing Address Fax Number:
214-432-9220

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1255 DRUMMERS LN
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
WAYNE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19087-1565
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-293-7413
Provider Business Practice Location Address Fax Number:
610-293-7459
Provider Enumeration Date:
07/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GLASSCOCK
Authorized Official First Name:
AMY
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
BILLING MANAGER
Authorized Official Telephone Number:
214-306-4520

Provider Taxonomy Codes

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

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





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