MEDICARE: SEASONS 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	HFID 03427	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3Z25SE	OTHER	MN	BC/BS PROVIDER NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114924255
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEASONS HOSPICE

Provider Business Mailing Address
First Line	:	1696 GREENVIEW DR SW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55902-1363
Country	:	US
Telephone Number	:	507-285-1930
Fax Number	:	507-282-2737

Provider Business Practice Location Address
First Line	:	1696 GREENVIEW DR SW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55902-1363
Country	:	US
Telephone Number	:	507-285-1930
Fax Number	:	507-282-2737

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	BEVERLY ANN HAYNES
Credential	:	RN, BSN
Telephone Number	:	507-285-1930

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	03/17/2014

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Directions to “SEASONS HOSPICE ” Practice Location

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