Provider Demographics
NPI:1891835716
Name:HOSPICE PREFERRED CHOICE, INC
Entity type:Organization
Organization Name:HOSPICE PREFERRED CHOICE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:RASMUSSEN-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-201-4840
Mailing Address - Street 1:1615 W BUSINESS HWY 60
Mailing Address - Street 2:SUITE A
Mailing Address - City:DEXTER
Mailing Address - State:MO
Mailing Address - Zip Code:63841-2718
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1615 W BUSINESS HWY 60
Practice Address - Street 2:SUITE A
Practice Address - City:DEXTER
Practice Address - State:MO
Practice Address - Zip Code:63841-2718
Practice Address - Country:US
Practice Address - Phone:573-624-3655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOMECARE PREFERRED CHOICE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-08
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO261636Medicare Oscar/Certification