MEDICARE: BISHOP 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
2	251G00000X	Community Based Hospice Care Agency	2287	TX

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	:	1992907521
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BISHOP HOSPICE, LLC

Provider Business Mailing Address
First Line	:	809 MEADOWSIDE CT
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75043-3721
Country	:	US
Telephone Number	:	972-770-0597
Fax Number	:	972-770-0598

Provider Business Practice Location Address
First Line	:	4402 BROADWAY BLVD STE 14A
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75043-8263
Country	:	US
Telephone Number	:	972-770-0597
Fax Number	:	972-770-0598

Authorized Official
Title or Position	:	CEO / ADMINISTRATOR
Name	:	SHIBU SAMUEL
Credential	:
Telephone Number	:	972-770-0597

Provider Enumeration Date	:	06/05/2007
Last Update Date	:	12/23/2024

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Directions to “BISHOP HOSPICE, LLC ” Practice Location

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