MEDICARE: AMERICAN 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
1	251G00000X	Community Based Hospice Care Agency	009252	TX
2	251G00000X	Community Based Hospice Care Agency	009855	TX
3	251G00000X	Community Based Hospice Care Agency	009257	TX
4	251G00000X	Community Based Hospice Care Agency	009256	TX

General Provider Information

NPI Number	:	1548246960
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN HOSPICE, INC

Provider Business Mailing Address
First Line	:	3124 SE LOOP 820
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76140-1031
Country	:	US
Telephone Number	:	817-551-0945
Fax Number	:	817-551-3800

Provider Business Practice Location Address
First Line	:	3124 SE LOOP 820
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76140-1031
Country	:	US
Telephone Number	:	817-551-0945
Fax Number	:	817-551-3800

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. DONALD L KING
Credential	:
Telephone Number	:	817-551-0945

Provider Enumeration Date	:	12/17/2005
Last Update Date	:	08/22/2020

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Directions to “AMERICAN HOSPICE, INC ” Practice Location

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