MEDICARE: HOSPICE OF CHENANGO COUNTY, 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	0824500F	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821095902
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPICE OF CHENANGO COUNTY, INC.

Provider Business Mailing Address
First Line	:	21 HAYES ST
Second Line	:
City	:	NORWICH
State	:	NY
Zip	:	13815-1617
Country	:	US
Telephone Number	:	607-334-3556
Fax Number	:	607-334-3688

Provider Business Practice Location Address
First Line	:	21 HAYES ST
Second Line	:
City	:	NORWICH
State	:	NY
Zip	:	13815-1617
Country	:	US
Telephone Number	:	607-334-3556
Fax Number	:	607-334-3688

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. PATRICIA M OUTHOUSE
Credential	:	BS, MA
Telephone Number	:	607-334-3556

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	05/22/2013

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