Healthcare Provider Details

I. General information

NPI: 1881693125
Provider Name (Legal Business Name): HOSPICE OF CENTRAL OHIO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 04/02/2020
Certification Date: 04/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2269 CHERRY VALLEY ROAD
NEWARK OH
43055-9323
US

IV. Provider business mailing address

2269 CHERRY VALLEY ROAD
NEWARK OH
43055-9323
US

V. Phone/Fax

Practice location:
  • Phone: 740-788-1400
  • Fax: 740-788-1401
Mailing address:
  • Phone: 740-788-1400
  • Fax: 740-788-1401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number0012HSP
License Number StateOH

VIII. Authorized Official

Name: MRS. RENEE A SPARKS
Title or Position: GENERAL MANAGER, EXECUTIVE VICE PRE
Credential: MSN, RN, CHPN
Phone: 740-788-1400