1578613246 NPI number — HERNANDO-PASCO 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 1578613246 NPI number — HERNANDO-PASCO HOSPICE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HERNANDO-PASCO 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:
1578613246
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/24/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12470 TELECOM DR STE 300W
Provider Second Line Business Mailing Address:
ATTENTION: COMPLIANCE
Provider Business Mailing Address City Name:
TEMPLE TERRACE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33637-0904
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-863-7971
Provider Business Mailing Address Fax Number:
727-868-9261

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6807 ROWAN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW PORT RICHEY
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34653-2952
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-863-7971
Provider Business Practice Location Address Fax Number:
727-868-9261
Provider Enumeration Date:
01/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SAUCIER
Authorized Official First Name:
SHARON
Authorized Official Middle Name:
PAMELA
Authorized Official Title or Position:
CHIEF COMPLIANCE & CLINICAL OFFICER
Authorized Official Telephone Number:
813-871-8031

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 028161100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 028161101 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 107652 . This is a "DEACTIVATED MEDICARE PART A NUMBER" identifier . This identifiers is of the category "OTHER".




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