Provider Demographics
NPI:1003921727
Name:A PINEYWOODS HOSPICE, INC.
Entity Type:Organization
Organization Name:A PINEYWOODS HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR OF FINANCE
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:NARANJO
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:936-634-1617
Mailing Address - Street 1:PO BOX 1743
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75902-1743
Mailing Address - Country:US
Mailing Address - Phone:936-634-1617
Mailing Address - Fax:936-634-7967
Practice Address - Street 1:103 CARRIAGE DR
Practice Address - Street 2:SUITE B
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-0880
Practice Address - Country:US
Practice Address - Phone:936-634-1617
Practice Address - Fax:936-634-7967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009142251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001012822Medicaid
TX451769OtherBLUE CROSS BLUE SHIELD
TX451769OtherBLUE CROSS BLUE SHIELD