=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760475255
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOSPICE OF SPOKANE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/30/2005
-----------------------------------------------------
Last Update Date | 07/16/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 121 S ARTHUR ST
-----------------------------------------------------
City | SPOKANE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99202-2253
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-456-0438
-----------------------------------------------------
Fax | 509-458-0359
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 121 S ARTHUR ST PO BOX 2215
-----------------------------------------------------
City | SPOKANE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99202-2253
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-456-0438
-----------------------------------------------------
Fax | 509-458-0359
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MS. GINA DRUMMOND
-----------------------------------------------------
Credential | RN, MSN
-----------------------------------------------------
Telephone | 509-456-0438
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 315D00000X
-----------------------------------------------------
Taxonomy Name | Inpatient Hospice
-----------------------------------------------------
License Number | IHS FS 00000337
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number | IS-337
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------