MEDICARE: ECHO HOSPICE OF OHIO, 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	:	1063008621
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ECHO HOSPICE OF OHIO, LLC

Provider Business Mailing Address
First Line	:	7817 IVANHOE AVE STE 101
Second Line	:
City	:	LA JOLLA
State	:	CA
Zip	:	92037-4541
Country	:	US
Telephone Number	:	918-576-3070
Fax Number	:	918-516-0609

Provider Business Practice Location Address
First Line	:	690 TAYLOR RD STE 110
Second Line	:
City	:	GAHANNA
State	:	OH
Zip	:	43230-3520
Country	:	US
Telephone Number	:	614-929-7930
Fax Number	:	614-965-6645

Authorized Official
Title or Position	:	MEMBER
Name	:	CHRIS LACKNER
Credential	:
Telephone Number	:	405-412-4909

Provider Enumeration Date	:	12/17/2020
Last Update Date	:	02/24/2026

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Directions to “ECHO HOSPICE OF OHIO, LLC ” Practice Location

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