Healthcare Provider Details

I. General information

NPI: 1013242551
Provider Name (Legal Business Name): COMMUNITY HOSPICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2009
Last Update Date: 03/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2029 S 3RD ST
IRONTON OH
45638-2476
US

IV. Provider business mailing address

1480 CARTER AVE
ASHLAND KY
41101-7546
US

V. Phone/Fax

Practice location:
  • Phone: 740-532-8841
  • Fax: 740-532-8843
Mailing address:
  • Phone: 606-329-1890
  • Fax: 606-329-0018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number0041HSP
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number0041HSP
License Number StateOH

VIII. Authorized Official

Name: MS. SUSAN D. HUNT
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 606-329-1890