Provider Demographics
NPI:1982266300
Name:ST. JOHNS HOSPICE LLC
Entity type:Organization
Organization Name:ST. JOHNS HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:HOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-366-8936
Mailing Address - Street 1:4414 CENTERVIEW STE 208
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-1432
Mailing Address - Country:US
Mailing Address - Phone:210-718-0551
Mailing Address - Fax:210-718-0554
Practice Address - Street 1:4414 CENTERVIEW STE 208
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-1432
Practice Address - Country:US
Practice Address - Phone:210-718-0551
Practice Address - Fax:210-718-0554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-05
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based