Provider Demographics
NPI:1871592444
Name:ESSENT PRMC LP HOSPICE
Entity type:Organization
Organization Name:ESSENT PRMC LP HOSPICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:C
Authorized Official - Last Name:KNIZLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-737-3205
Mailing Address - Street 1:PO BOX 9070
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75461-9070
Mailing Address - Country:US
Mailing Address - Phone:903-737-3257
Mailing Address - Fax:903-737-3375
Practice Address - Street 1:820 CLARKSVILLE ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-6027
Practice Address - Country:US
Practice Address - Phone:903-737-3257
Practice Address - Fax:903-737-3375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1012744Medicaid
TX451510Medicare ID - Type Unspecified