Healthcare Provider Details

I. General information

NPI: 1306843354
Provider Name (Legal Business Name): ALL CARE HOSPICE CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2005
Last Update Date: 05/10/2022
Certification Date: 05/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 E BROAD ST STE D
HAZLETON PA
18201-5695
US

IV. Provider business mailing address

1710 E BROAD ST STE D
HAZLETON PA
18201-5695
US

V. Phone/Fax

Practice location:
  • Phone: 570-459-2004
  • Fax: 570-459-3009
Mailing address:
  • Phone: 570-459-2004
  • Fax: 570-459-3009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier01641305002
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: MARIO IEZZONI
Title or Position: CFO VICE PRESIDENT
Credential: CPA
Phone: 570-459-2004