MEDICARE: MT HOOD HOSPICE

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
1	251G00000X	Community Based Hospice Care Agency	1983-001	OR

Other Identifiers

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

General Provider Information

NPI Number	:	1093717340
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MT HOOD HOSPICE

Provider Business Mailing Address
First Line	:	PO BOX 1269
Second Line	:	39641 SCENIC ST.
City	:	SANDY
State	:	OR
Zip	:	97055-1269
Country	:	US
Telephone Number	:	503-668-5545
Fax Number	:	503-668-7951

Provider Business Practice Location Address
First Line	:	39085 PIONEER BLVD STE 1018
Second Line	:
City	:	SANDY
State	:	OR
Zip	:	97055-8081
Country	:	US
Telephone Number	:	503-668-5545
Fax Number	:	503-668-7951

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	RHONDA CHRISTINE FRANKE
Credential	:
Telephone Number	:	503-668-5545

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	10/18/2021

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Directions to “MT HOOD HOSPICE ” Practice Location

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