Provider Demographics
NPI:1073805420
Name:HOSPICE OF TUSCARAWAS COUNTY, INC
Entity Type:Organization
Organization Name:HOSPICE OF TUSCARAWAS COUNTY, INC
Other - Org Name:COMMUNITY HOSPICE PALLIATIVE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:OTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-343-7605
Mailing Address - Street 1:716 COMMERCIAL AVE SW
Mailing Address - Street 2:
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663-9367
Mailing Address - Country:US
Mailing Address - Phone:330-343-7605
Mailing Address - Fax:330-343-3542
Practice Address - Street 1:716 COMMERCIAL AVE SW
Practice Address - Street 2:
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663-9367
Practice Address - Country:US
Practice Address - Phone:330-343-7605
Practice Address - Fax:330-343-3542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-04
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.061811207Q00000X
OH35.055339207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty