Provider Demographics
NPI:1447845185
Name:HERNANDO-PASCO HOSPICE, INC.
Entity type:Organization
Organization Name:HERNANDO-PASCO HOSPICE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF LEGAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCCIARELLI
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:813-871-8075
Mailing Address - Street 1:12470 TELECOM DRIVE, SUITE 301
Mailing Address - Street 2:ATTENTION: COMPLIANCE
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-0904
Mailing Address - Country:US
Mailing Address - Phone:813-871-8075
Mailing Address - Fax:
Practice Address - Street 1:12254 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-2626
Practice Address - Country:US
Practice Address - Phone:352-616-0795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HERNANDO-PASCO HOSPICE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-04
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL299995071OtherAGENCY FOR HEALTH CARE ADMINISTRATION