Provider Demographics
NPI:1144375585
Name:COMMUNITY HOSPICE, INC.
Entity type:Organization
Organization Name:COMMUNITY HOSPICE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:606-329-1890
Mailing Address - Street 1:1480 CARTER AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-7546
Mailing Address - Country:US
Mailing Address - Phone:606-329-1890
Mailing Address - Fax:606-329-0018
Practice Address - Street 1:1480 CARTER AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7546
Practice Address - Country:US
Practice Address - Phone:606-329-1890
Practice Address - Fax:606-329-0018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2017-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
K201060OtherMEDICARE PTAN
KY977602Medicare ID - Type UnspecifiedARNP
KY9776Medicare ID - Type UnspecifiedPART B
KY977601Medicare ID - Type UnspecifiedPHYSICIAN