Provider Demographics
NPI:1114912003
Name:FAMILY HOSPICE AND PALLIATIVE CARE
Entity Type:Organization
Organization Name:FAMILY HOSPICE AND PALLIATIVE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:IVANKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-572-8811
Mailing Address - Street 1:701 N. HERMITAGE ROAD
Mailing Address - Street 2:COLONIAL SQUARE BUILDING 1, SUITE 5
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-3250
Mailing Address - Country:US
Mailing Address - Phone:724-983-6020
Mailing Address - Fax:412-572-8826
Practice Address - Street 1:701 N. HERMITAGE ROAD
Practice Address - Street 2:COLONIAL SQUARE BUILDING 1, SUITE 5
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-3250
Practice Address - Country:US
Practice Address - Phone:724-983-6020
Practice Address - Fax:412-572-8826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-16
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA155899251G00000X
OH0133HSP251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100776420Medicaid
PA391558Medicare ID - Type UnspecifiedHOSPICE