Provider Demographics
NPI:1548246960
Name:AMERICAN HOSPICE, INC
Entity type:Organization
Organization Name:AMERICAN HOSPICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:L
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-551-0945
Mailing Address - Street 1:3124 SE LOOP 820
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76140-1031
Mailing Address - Country:US
Mailing Address - Phone:817-551-0945
Mailing Address - Fax:817-551-3800
Practice Address - Street 1:3124 SE LOOP 820
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76140-1031
Practice Address - Country:US
Practice Address - Phone:817-551-0945
Practice Address - Fax:817-551-3800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009252251G00000X
TX009855251G00000X
TX009257251G00000X
TX009256251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX451686Medicare ID - Type UnspecifiedHOUSTON MCARE
TX451704Medicare ID - Type UnspecifiedFORT WORTH MCARE
TX451770Medicare ID - Type UnspecifiedJACKSBORO MCARE
TX451584Medicare ID - Type UnspecifiedDALLAS MCARE