MEDICARE: YELLOW ROSE HOSPICE 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

General Provider Information

NPI Number	:	1467000489
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YELLOW ROSE HOSPICE CARE, INC.

Provider Business Mailing Address
First Line	:	2819 NW LOOP 410 STE F
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-5105
Country	:	US
Telephone Number	:	210-797-7316
Fax Number	:

Provider Business Practice Location Address
First Line	:	2819 NW LOOP 410 STE F
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-5105
Country	:	US
Telephone Number	:	210-797-7316
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KIMBERLEY WINN
Credential	:
Telephone Number	:	210-797-7316

Provider Enumeration Date	:	09/03/2019
Last Update Date	:	02/01/2022

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