Provider Demographics
NPI:1528504651
Name:ALL CARE HOSPICE INC
Entity type:Organization
Organization Name:ALL CARE HOSPICE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JO-MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:KOOPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-598-2454
Mailing Address - Street 1:210 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01901-1536
Mailing Address - Country:US
Mailing Address - Phone:781-598-2454
Mailing Address - Fax:
Practice Address - Street 1:210 MARKET ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1536
Practice Address - Country:US
Practice Address - Phone:781-598-2454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALL CARE HOSPICE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-12
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM2187101Medicare Oscar/Certification