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NPI Code Detail

MEDICARE: HOSPICE OF WICHITA FALLS, INC.

MEDICARE: HOSPICE OF WICHITA FALLS, 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
1251G00000XCommunity Based Hospice Care Agency001947TX

General Provider Information

NPI Number : 1770583254
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOSPICE OF WICHITA FALLS, INC.
Provider Business Mailing Address
First Line : PO BOX 4804
Second Line :
City : WICHITA FALLS
State : TX
Zip : 76308-0804
Country : US
Telephone Number : 940-691-0982
Fax Number : 940-691-1608
Provider Business Practice Location Address
First Line : 4909 JOHNSON RD
Second Line :
City : WICHITA FALLS
State : TX
Zip : 76310-2547
Country : US
Telephone Number : 940-691-0982
Fax Number : 940-691-1608
Authorized Official
Title or Position : CEO
Name : MRS. JAN MARIE BANTA
Credential : R.N.
Telephone Number : 940-691-0982
Provider Enumeration Date : 07/27/2005
Last Update Date : 08/22/2020

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Practice Fax: 940-687-6000

Directions to “HOSPICE OF WICHITA FALLS, INC. ” Practice Location

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