Provider Demographics
NPI:1548508062
Name:OTTERBEIN HOSPICE LLC
Entity type:Organization
Organization Name:OTTERBEIN HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AVP FINANCE/CONTROLLER
Authorized Official - Prefix:MS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:C
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-933-5401
Mailing Address - Street 1:3855 LOWER MARKET ST STE 300
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-7654
Mailing Address - Country:US
Mailing Address - Phone:513-933-5401
Mailing Address - Fax:
Practice Address - Street 1:570 NORTH STATE ROUTE 741 SUITE 218
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-8839
Practice Address - Country:US
Practice Address - Phone:513-933-5400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OTTERBEIN HOMES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-01-17
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based