Provider Demographics
NPI:1124025697
Name:HOSPICE OF THE PANHANDLE, INC.
Entity Type:Organization
Organization Name:HOSPICE OF THE PANHANDLE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:COGSWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-264-0406
Mailing Address - Street 1:330 HOSPICE LN
Mailing Address - Street 2:
Mailing Address - City:KEARNEYSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25430-4547
Mailing Address - Country:US
Mailing Address - Phone:304-264-0406
Mailing Address - Fax:304-264-0409
Practice Address - Street 1:330 HOSPICE LN
Practice Address - Street 2:
Practice Address - City:KEARNEYSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25430-4547
Practice Address - Country:US
Practice Address - Phone:304-264-0406
Practice Address - Fax:304-264-0409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV07251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810019149Medicaid
WV511507Medicare Oscar/Certification
WV0005538100Medicaid
WV0005134000Medicaid