MEDICARE: COMFORTING HANDS HOSPICE OF GROVE 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
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1528652328
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMFORTING HANDS HOSPICE OF GROVE LLC

Provider Business Mailing Address
First Line	:	1015 S MAIN ST
Second Line	:
City	:	GROVE
State	:	OK
Zip	:	74344-2847
Country	:	US
Telephone Number	:	918-786-0441
Fax Number	:

Provider Business Practice Location Address
First Line	:	1015 S MAIN ST
Second Line	:
City	:	GROVE
State	:	OK
Zip	:	74344-2847
Country	:	US
Telephone Number	:	918-786-0441
Fax Number	:	918-786-0313

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	ANGIE K BIDLEMAN
Credential	:	RN
Telephone Number	:	918-786-0441

Provider Enumeration Date	:	02/23/2021
Last Update Date	:	05/30/2023

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