Provider Demographics
NPI:1033669973
Name:WKM HOSPICE LLC
Entity Type:Organization
Organization Name:WKM HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SHARMATHA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJESH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-887-8223
Mailing Address - Street 1:100 N CENTRAL EXPRESSWAY
Mailing Address - Street 2:SUITE 190,ROOM 106
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-5833
Mailing Address - Country:US
Mailing Address - Phone:972-833-4660
Mailing Address - Fax:972-833-4661
Practice Address - Street 1:3014 E US HIGHWAY 377
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76049-7403
Practice Address - Country:US
Practice Address - Phone:972-833-4660
Practice Address - Fax:972-833-4661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-04
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based