MEDICARE: PIONEER HOSPICE CARE SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1043688476
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIONEER HOSPICE CARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	333 N SHILOH RD STE 111
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75042-6613
Country	:	US
Telephone Number	:	469-277-8053
Fax Number	:	469-626-3499

Provider Business Practice Location Address
First Line	:	333 N SHILOH RD STE 111
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75042-6613
Country	:	US
Telephone Number	:	469-277-8053
Fax Number	:	469-626-3499

Authorized Official
Title or Position	:	ADMINISTRATOR / DIRECTOR OF NURSES
Name	:	TRACY GALVAN
Credential	:	RN, CHPN
Telephone Number	:	469-277-8053

Provider Enumeration Date	:	09/02/2015
Last Update Date	:	09/02/2015

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