Provider Demographics
NPI:1316265481
Name:TLC HOSPICE INC
Entity type:Organization
Organization Name:TLC HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:FREY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:267-684-6736
Mailing Address - Street 1:826 BUSTLETON PIKE
Mailing Address - Street 2:SUITE 201B
Mailing Address - City:FEASTERVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19053
Mailing Address - Country:US
Mailing Address - Phone:267-684-6736
Mailing Address - Fax:267-684-6769
Practice Address - Street 1:826 BUSTLETON PIKE
Practice Address - Street 2:SUITE 201B
Practice Address - City:FEASTERVILLE
Practice Address - State:PA
Practice Address - Zip Code:19053
Practice Address - Country:US
Practice Address - Phone:267-684-6736
Practice Address - Fax:267-684-6769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-13
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251G00000X
PA17301601251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA391730Medicare UPIN