MEDICARE: HOSPICE OF SIOUXLAND

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	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician
2	251G00000X	Community Based Hospice Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063485365
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPICE OF SIOUXLAND

Provider Business Mailing Address
First Line	:	309 COOK ST
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51103-3707
Country	:	US
Telephone Number	:	712-233-4144
Fax Number	:

Provider Business Practice Location Address
First Line	:	309 COOK ST
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51103-3707
Country	:	US
Telephone Number	:	712-233-4144
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	JACQUELINE M. KREBER
Credential	:
Telephone Number	:	712-252-9301

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	01/08/2024

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Directions to “HOSPICE OF SIOUXLAND ” Practice Location

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