MEDICARE: FRONTIER HOME HEALTH AND 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
1	251E00000X	Home Health Agency	60066213	WA

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	:	1790027480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRONTIER HOME HEALTH AND HOSPICE, LLC

Provider Business Mailing Address
First Line	:	53 RIVER ST
Second Line	:	YANKEE PROFESSIONAL BUILDING
City	:	MILFORD
State	:	CT
Zip	:	06460-3346
Country	:	US
Telephone Number	:	203-693-3840
Fax Number	:	203-693-3841

Provider Business Practice Location Address
First Line	:	800 JASMINE ST
Second Line	:	SUITE 2
City	:	OMAK
State	:	WA
Zip	:	98841-9501
Country	:	US
Telephone Number	:	509-422-6721
Fax Number	:	509-422-1835

Authorized Official
Title or Position	:	DIRECTOR OF REIMBURSEMENT
Name	:	JUDITH B GESSFORD
Credential	:
Telephone Number	:	203-693-3840

Provider Enumeration Date	:	03/21/2013
Last Update Date	:	02/14/2014

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