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NPI Code Detail

MEDICARE: SERENITY HOSPICECARE

MEDICARE: SERENITY HOSPICECARE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251G00000XCommunity Based Hospice Care AgencyMO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053316091
Entity Type Code : Organization
Provider Name (Legal Business Name) : SERENITY HOSPICECARE
Provider Business Mailing Address
First Line : PO BOX 1000
Second Line : 5272 FLAT RIVER RD MINERAL AREA COLLEGE
City : PARK HILLS
State : MO
Zip : 63601-1000
Country : US
Telephone Number : 573-431-0162
Fax Number : 573-431-6304
Provider Business Practice Location Address
First Line : 5272 FLAT RIVER RD
Second Line : MINERAL AREA COLLEGE
City : PARK HILLS
State : MO
Zip : 63601-1000
Country : US
Telephone Number : 573-431-0162
Fax Number : 573-431-6304
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. FRED MCDANIEL
Credential :
Telephone Number : 573-431-0162
Provider Enumeration Date : 06/16/2005
Last Update Date : 03/23/2011

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Directions to “SERENITY HOSPICECARE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.