MEDICARE: XL HOSPICE 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	0699275-7	OR
2	251G00000X	Community Based Hospice Care Agency	0001449710	ID

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	:	1952308751
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	XL HOSPICE INC

Provider Business Mailing Address
First Line	:	2480 HIGHWAY 52
Second Line	:
City	:	PAYETTE
State	:	ID
Zip	:	83661-5536
Country	:	US
Telephone Number	:	208-642-9222
Fax Number	:	208-642-9224

Provider Business Practice Location Address
First Line	:	2480 HIGHWAY 52
Second Line	:
City	:	PAYETTE
State	:	ID
Zip	:	83661-5536
Country	:	US
Telephone Number	:	208-642-9222
Fax Number	:	208-642-9224

Authorized Official
Title or Position	:	OWNER
Name	:	BARBARA B OLSON
Credential	:
Telephone Number	:	208-642-9222

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	08/18/2008

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Directions to “XL HOSPICE INC ” Practice Location

Language	Start Address	Practice Location

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