MEDICARE: PRIDE HOSPICE CARE 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	:	1821458456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIDE HOSPICE CARE LLC

Provider Business Mailing Address
First Line	:	7304 SHADY HOLLOW LN
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76182-7710
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7304 SHADY HOLLOW LN
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76182-7710
Country	:	US
Telephone Number	:	210-857-5350
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	ANN LOZANO
Credential	:
Telephone Number	:	210-857-5350

Provider Enumeration Date	:	02/24/2016
Last Update Date	:	04/04/2017

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