Provider Demographics
NPI:1427426709
Name:PENN HOSPICE, INC.
Entity type:Organization
Organization Name:PENN HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:CARTER
Authorized Official - Last Name:DEYARMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-846-4160
Mailing Address - Street 1:313 W HIGH ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:EBENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15931-1549
Mailing Address - Country:US
Mailing Address - Phone:814-846-4160
Mailing Address - Fax:814-419-8218
Practice Address - Street 1:313 W HIGH ST
Practice Address - Street 2:SUITE 210
Practice Address - City:EBENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15931-1549
Practice Address - Country:US
Practice Address - Phone:814-846-4160
Practice Address - Fax:814-419-8218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-03
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA17761601251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based