Provider Demographics
NPI:1174560429
Name:HOSPICE PREFERRED CHOICE, INC.
Entity type:Organization
Organization Name:HOSPICE PREFERRED CHOICE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:RASMUSSEN-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-201-4835
Mailing Address - Street 1:2820 W MARKET ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-4043
Mailing Address - Country:US
Mailing Address - Phone:330-835-3813
Mailing Address - Fax:
Practice Address - Street 1:2820 W MARKET ST
Practice Address - Street 2:SUITE 110
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-4043
Practice Address - Country:US
Practice Address - Phone:330-835-3813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOMECARE PREFERRED CHOICE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-02
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2583744Medicaid
OH361624Medicare Oscar/Certification