Healthcare Provider Details

I. General information

NPI: 1043295611
Provider Name (Legal Business Name): HOSPICE OF SOUTHWEST OHIO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 04/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7625 CAMARGO RD
CINCINNATI OH
45243-3107
US

IV. Provider business mailing address

7625 CAMARGO RD
CINCINNATI OH
45243-3107
US

V. Phone/Fax

Practice location:
  • Phone: 513-770-0820
  • Fax: 513-770-0848
Mailing address:
  • Phone: 513-770-0820
  • Fax: 513-770-0848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number0150HSP
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL HAWS
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 513-770-0820