Provider Demographics
NPI:1720239049
Name:HORIZONS HOSPICE, LLC
Entity type:Organization
Organization Name:HORIZONS HOSPICE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:V.P. OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:REZK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-946-5017
Mailing Address - Street 1:309 E PLANK RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-4111
Mailing Address - Country:US
Mailing Address - Phone:814-946-5017
Mailing Address - Fax:814-946-5323
Practice Address - Street 1:600 CLARK AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1433
Practice Address - Country:US
Practice Address - Phone:610-337-1101
Practice Address - Fax:610-337-1106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-06
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA391716Medicare Oscar/Certification