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NPI Code Detail

MEDICARE: FAIRMONT HOSPICE NORTH LLC

MEDICARE: FAIRMONT HOSPICE NORTH 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
1251G00000XCommunity Based Hospice Care Agency

General Provider Information

NPI Number : 1942902929
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAIRMONT HOSPICE NORTH LLC
Provider Business Mailing Address
First Line : 300 JACKSON ST
Second Line :
City : RICHMOND
State : TX
Zip : 77469-3109
Country : US
Telephone Number : 832-434-2670
Fax Number :
Provider Business Practice Location Address
First Line : 300 JACKSON ST
Second Line :
City : RICHMOND
State : TX
Zip : 77469-3109
Country : US
Telephone Number : 832-434-2670
Fax Number :
Authorized Official
Title or Position : MANAGING MEMBER
Name : NIDHU KURUP
Credential :
Telephone Number : 832-434-2670
Provider Enumeration Date : 03/21/2023
Last Update Date : 03/21/2023

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Directions to “FAIRMONT HOSPICE NORTH LLC ” Practice Location

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