=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366449951
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SNOWLINE HOSPICE OF EL DORADO COUNTY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/28/2005
-----------------------------------------------------
Last Update Date | 08/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6520 PLEASANT VALLEY RD
-----------------------------------------------------
City | DIAMOND SPRINGS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95619
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-621-7820
-----------------------------------------------------
Fax | 530-621-4503
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6520 PLEASANT VALLEY RD
-----------------------------------------------------
City | DIAMOND SPRINGS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95619-9512
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-621-7820
-----------------------------------------------------
Fax | 530-621-4503
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF EXECUTIVE OFFICER
-----------------------------------------------------
Name | MR. TIMOTHY MEADOWS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 530-621-7820
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number | 100000610
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------