MEDICARE: COMPANION HOSPICE LLC

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	4157	OK

General Provider Information

NPI Number	:	1922007806
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPANION HOSPICE LLC

Provider Business Mailing Address
First Line	:	1314 E OKLAHOMA AVE
Second Line	:
City	:	GUTHRIE
State	:	OK
Zip	:	73044-3757
Country	:	US
Telephone Number	:	405-293-9000
Fax Number	:	405-293-9001

Provider Business Practice Location Address
First Line	:	1314 E OKLAHOMA AVE
Second Line	:
City	:	GUTHRIE
State	:	OK
Zip	:	73044-3757
Country	:	US
Telephone Number	:	405-282-3980
Fax Number	:	405-282-3981

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. TANDIE HASTINGS
Credential	:
Telephone Number	:	405-282-6285

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	05/21/2024

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Directions to “COMPANION HOSPICE LLC ” Practice Location

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