Provider Demographics
NPI:1720131238
Name:OHI HOSPICE, INC.
Entity type:Organization
Organization Name:OHI HOSPICE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KENT
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-823-2631
Mailing Address - Street 1:7575 PARAGON RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-5316
Mailing Address - Country:US
Mailing Address - Phone:937-256-4490
Mailing Address - Fax:937-249-0239
Practice Address - Street 1:7575 PARAGON RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-5316
Practice Address - Country:US
Practice Address - Phone:937-256-4490
Practice Address - Fax:937-249-0239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0144HSP251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2568412Medicaid
OH361622Medicare ID - Type UnspecifiedPROVIDER NUMBER