Provider Demographics
NPI:1093031775
Name:PATHWAY HOSPICE, LLC
Entity Type:Organization
Organization Name:PATHWAY HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ALECIA
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:214-377-9377
Mailing Address - Street 1:1101 E ARAPAHO RD STE 130
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-2352
Mailing Address - Country:US
Mailing Address - Phone:214-377-9377
Mailing Address - Fax:214-292-9604
Practice Address - Street 1:1101 E ARAPAHO RD STE 130
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-2352
Practice Address - Country:US
Practice Address - Phone:214-377-9377
Practice Address - Fax:214-292-9604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-20
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001027006Medicaid