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General NPI Number Information
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NPI Number | 1073029096
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Entity Type | Organization
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Legal Business Name | HOPE PALLIATIVE CARE
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Dates
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Enumeration Date | 12/28/2017
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Last Update Date | 12/28/2017
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Provider Practice Location Address
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Address Line | 10754 INDIAN HEAD INDUSTRIAL BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63132-1102
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Country | US
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Telephone | 314-984-9800
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Fax |
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Provider Business Mailing Address
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Address Line | 10754 INDIAN HEAD INDUSTRIAL BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63132-1102
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Country | US
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Telephone | 314-984-9800
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL FULTON MCNULTY
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Credential |
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Telephone | 314-984-9800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 2013006531
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License Number State | MO
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