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NPI Code Detail

MEDICARE: ABC HOSPICE, INC.

MEDICARE: ABC HOSPICE, INC.
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
1163WH0200XHome Health Registered Nurse
2163WH1000XHospice Registered Nurse
3251J00000XNursing Care Agency
4253Z00000XIn Home Supportive Care Agency
5251G00000XCommunity Based Hospice Care Agency

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 : 1447999883
Entity Type Code : Organization
Provider Name (Legal Business Name) : ABC HOSPICE, INC.
Provider Business Mailing Address
First Line : 570 W 15TH ST
Second Line :
City : IDAHO FALLS
State : ID
Zip : 83402-4269
Country : US
Telephone Number : 208-525-6104
Fax Number : 208-525-6106
Provider Business Practice Location Address
First Line : 570 W 15TH ST
Second Line :
City : IDAHO FALLS
State : ID
Zip : 83402-4269
Country : US
Telephone Number : 208-525-6104
Fax Number : 208-525-6106
Authorized Official
Title or Position : PRESIDENT
Name : PARALEA FURNISS
Credential :
Telephone Number : 208-200-6100
Provider Enumeration Date : 06/02/2022
Last Update Date : 06/02/2022

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Directions to “ABC HOSPICE, INC. ” Practice Location

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