Healthcare Provider Details

I. General information

NPI: 1366583809
Provider Name (Legal Business Name): HOSPICE PREFERRED CHOICE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 07/06/2020
Certification Date: 07/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4427 GARWOOD PL
RICHMOND IN
47374-7828
US

IV. Provider business mailing address

3854 AMERICAN WAY STE A
BATON ROUGE LA
70816-4897
US

V. Phone/Fax

Practice location:
  • Phone: 765-962-1949
  • Fax: 765-935-4079
Mailing address:
  • Phone: 225-292-2031
  • Fax: 225-295-9678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

Name: PAUL KUSSEROW
Title or Position: PRESIDENT
Credential:
Phone: 225-292-2031