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NPI Code Detail

MEDICARE: BENEVOLENT HOSPICE LLC

MEDICARE: BENEVOLENT HOSPICE 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
1251G00000XCommunity Based Hospice Care Agency

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
167-1665OTHERMEDICARE PTAN

General Provider Information

NPI Number : 1144558289
Entity Type Code : Organization
Provider Name (Legal Business Name) : BENEVOLENT HOSPICE LLC
Provider Business Mailing Address
First Line : 9555 CANTURA CRST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78250-1719
Country : US
Telephone Number : 210-681-2140
Fax Number : 210-681-3148
Provider Business Practice Location Address
First Line : 12740 BANDERA RD
Second Line : SUITE 110
City : HELOTES
State : TX
Zip : 78023-4327
Country : US
Telephone Number : 210-681-2140
Fax Number : 210-681-3148
Authorized Official
Title or Position : OWNER
Name : MR. JAMES FRANKLIN THOMAS JR.
Credential :
Telephone Number : 210-681-2140
Provider Enumeration Date : 12/01/2009
Last Update Date : 05/26/2016

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Directions to “BENEVOLENT HOSPICE LLC ” Practice Location

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