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General NPI Number Information
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NPI Number | 1114001435
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Entity Type | Organization
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Legal Business Name | HOSPICE OF SAN ANGELO INC
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 36 EAST TWOHIG SUITE 1100
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City | SAN ANGELO
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State | TX
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Zip | 76903
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Country | US
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Telephone | 325-658-6524
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Fax | 325-658-8895
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Provider Business Mailing Address
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Address Line | PO BOX 471
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City | SAN ANGELO
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State | TX
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Zip | 76902
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DAVID W MCBRIDE
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Credential | MS
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Telephone | 325-658-6524
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 002018
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License Number State | TX
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