MEDICARE: NATIONAL 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	6180442	KS

General Provider Information

NPI Number	:	1578765046
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL HOSPICE, INC

Provider Business Mailing Address
First Line	:	319 N DOWELL ST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67206-2789
Country	:	US
Telephone Number	:	316-682-6649
Fax Number	:	316-682-6649

Provider Business Practice Location Address
First Line	:	319 N DOWELL ST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67206-2789
Country	:	US
Telephone Number	:	316-682-6649
Fax Number	:	316-682-6649

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MIKE NICHOLAS
Credential	:	RN
Telephone Number	:	316-682-6649

Provider Enumeration Date	:	06/05/2007
Last Update Date	:	09/08/2011

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