1922354638 NPI number — CIMA HOSPICE OF TEXARKANA, L.L.C.

Table of content: (NPI 1922354638)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922354638 NPI number — CIMA HOSPICE OF TEXARKANA, L.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CIMA HOSPICE OF TEXARKANA, L.L.C.
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:
1922354638
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/30/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3010 LYNDON B JOHNSON FWY STE 1100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75234-2712
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-379-1600
Provider Business Mailing Address Fax Number:
903-537-8420

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4025 LAMAR AVE STE 130A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARIS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75462-5244
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-794-2462
Provider Business Practice Location Address Fax Number:
903-306-2420
Provider Enumeration Date:
07/31/2012

Additional Information

Authorized Official

Authorized Official Last Name:
MONASTIERE
Authorized Official First Name:
KATIE
Authorized Official Middle Name:
Authorized Official Title or Position:
COMPLIANCE PRIVACY&SAFETY OFFICER
Authorized Official Telephone Number:
800-379-1600

Provider Taxonomy Codes

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

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

  • Identifier: 001025966 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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