Provider Demographics
NPI:1043890726
Name:HALLWAY HOSPICE LLC
Entity Type:Organization
Organization Name:HALLWAY HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:925-301-8869
Mailing Address - Street 1:7027 DUBLIN BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-3018
Mailing Address - Country:US
Mailing Address - Phone:925-301-8869
Mailing Address - Fax:925-301-8891
Practice Address - Street 1:7027 DUBLIN BLVD STE 120
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-3018
Practice Address - Country:US
Practice Address - Phone:925-301-8869
Practice Address - Fax:925-301-8891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-08
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1922546605OtherNPI