MEDICARE: HOPE HOSPICE AND PALLIATIVE CARE INC

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	43180200	WI

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

General Provider Information

NPI Number	:	1164411450
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPE HOSPICE AND PALLIATIVE CARE INC

Provider Business Mailing Address
First Line	:	537 W BROADWAY AVE
Second Line	:
City	:	MEDFORD
State	:	WI
Zip	:	54451-1610
Country	:	US
Telephone Number	:	715-748-3434
Fax Number	:	715-748-1268

Provider Business Practice Location Address
First Line	:	537 W BROADWAY AVE
Second Line	:
City	:	MEDFORD
State	:	WI
Zip	:	54451-1610
Country	:	US
Telephone Number	:	715-748-3434
Fax Number	:	715-748-1268

Authorized Official
Title or Position	:	DIRECTOR
Name	:	NICOLE SYRYCZUK
Credential	:
Telephone Number	:	715-748-3434

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	10/10/2023

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