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NPI Code Detail

MEDICARE: HOSPICE OF NORTH IDAHO INC

MEDICARE: HOSPICE OF NORTH IDAHO 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
1251G00000XCommunity Based Hospice Care AgencyID

Other Identifiers

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

General Provider Information

NPI Number : 1245235878
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOSPICE OF NORTH IDAHO INC
Provider Business Mailing Address
First Line : 2290 W PRAIRIE AVE
Second Line :
City : COEUR D ALENE
State : ID
Zip : 83815-8424
Country : US
Telephone Number : 208-772-7994
Fax Number :
Provider Business Practice Location Address
First Line : 2290 W PRAIRIE AVE
Second Line :
City : COEUR D ALENE
State : ID
Zip : 83815-8424
Country : US
Telephone Number : 208-772-7994
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF FINANCE
Name : ASHLEY TENNIS
Credential :
Telephone Number : 208-772-7994
Provider Enumeration Date : 06/20/2005
Last Update Date : 11/06/2025

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Directions to “HOSPICE OF NORTH IDAHO INC ” Practice Location

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