Provider Demographics
NPI:1225117161
Name:OPTION CARE ENTERPRISES, INC.
Entity Type:Organization
Organization Name:OPTION CARE ENTERPRISES, INC.
Other - Org Name:MISSOURI RIVER HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-879-6137
Mailing Address - Street 1:1278 PAYSPHERE CIR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-0012
Mailing Address - Country:US
Mailing Address - Phone:800-879-6137
Mailing Address - Fax:847-913-9024
Practice Address - Street 1:1410 HERIFORD RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65202-1907
Practice Address - Country:US
Practice Address - Phone:800-456-0417
Practice Address - Fax:573-814-7110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO012-7HO251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO820654201Medicaid
MO820654201Medicaid