Provider Demographics
NPI:1043854235
Name:GOSHEN HOSPICE AND PALLIATIVE CARE
Entity Type:Organization
Organization Name:GOSHEN HOSPICE AND PALLIATIVE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:KATRICIA
Authorized Official - Middle Name:LYNETTE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-701-7696
Mailing Address - Street 1:7936 PLAYERS FOREST DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-9171
Mailing Address - Country:US
Mailing Address - Phone:901-795-5949
Mailing Address - Fax:901-795-3940
Practice Address - Street 1:7936 PLAYERS FOREST DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-9171
Practice Address - Country:US
Practice Address - Phone:901-795-5949
Practice Address - Fax:901-795-3940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-31
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based