Healthcare Provider Details
I. General information
NPI: 1518962828
Provider Name (Legal Business Name): HOSPICE OF GUERNSEY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/15/2005
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9711 E PIKE RD
CAMBRIDGE OH
43725-8936
US
IV. Provider business mailing address
PO BOX 1165
CAMBRIDGE OH
43725-6165
US
V. Phone/Fax
- Phone: 740-432-7440
- Fax: 740-432-7424
- Phone: 740-432-7440
- Fax: 740-432-7424
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207PH0002X |
| Taxonomy | Hospice and Palliative Medicine (Emergency Medicine) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QH0002X |
| Taxonomy | Hospice and Palliative Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086H0002X |
| Taxonomy | Hospice and Palliative Medicine (Surgery) Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | 0019HSP |
| License Number State | OH |
VIII. Authorized Official
Name:
LORRAINE
TEAGUE
Title or Position: EXECUTIVE DIRECTOR
Credential: RN
Phone: 740-432-7440