MEDICARE: HOSPICE OF SOUTH TEXAS, 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	001930	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HH6922	OTHER	TX	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881697274
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPICE OF SOUTH TEXAS, INC

Provider Business Mailing Address
First Line	:	605 E LOCUST AVE
Second Line	:
City	:	VICTORIA
State	:	TX
Zip	:	77901-3933
Country	:	US
Telephone Number	:	361-572-4300
Fax Number	:	361-572-8109

Provider Business Practice Location Address
First Line	:	605 E LOCUST AVE
Second Line	:
City	:	VICTORIA
State	:	TX
Zip	:	77901-3933
Country	:	US
Telephone Number	:	361-572-4300
Fax Number	:	361-572-8109

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MRS. ANNE MCINTOSH
Credential	:
Telephone Number	:	361-572-4300

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	01/03/2020

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