Healthcare Provider Details

I. General information

NPI: 1659301539
Provider Name (Legal Business Name): HCA ACQUISITION HOLDINGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 BUCKLEY DR STE B
ROCKFORD IL
61107-5806
US

IV. Provider business mailing address

185 BUCKLEY DR STE B
ROCKFORD IL
61107-5806
US

V. Phone/Fax

Practice location:
  • Phone: 815-316-2700
  • Fax: 815-316-2702
Mailing address:
  • Phone: 815-316-2700
  • Fax: 815-316-2702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number1712953
License Number StateIL

VIII. Authorized Official

Name: HEATH A BARTNESS
Title or Position: CEO
Credential:
Phone: 651-735-3656