Provider Demographics
NPI:1043294689
Name:HENDRICK HOSPICE CARE, INC.
Entity type:Organization
Organization Name:HENDRICK HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS SERVICES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PARKER
Authorized Official - Last Name:KIDD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-670-6975
Mailing Address - Street 1:1651 PINE ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-3041
Mailing Address - Country:US
Mailing Address - Phone:325-670-2273
Mailing Address - Fax:325-670-3233
Practice Address - Street 1:1651 PINE ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601
Practice Address - Country:US
Practice Address - Phone:325-670-2273
Practice Address - Fax:325-670-3233
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HENDRICK MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-12-06
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX002613251G00000X
251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000203600Medicaid
TX000203600Medicaid