Provider Demographics
NPI:1225580665
Name:COLER HOSPICE, LTD
Entity Type:Organization
Organization Name:COLER HOSPICE, LTD
Other - Org Name:SHRIVERS HOMETOWN HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:COLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-487-1241
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43702-0008
Mailing Address - Country:US
Mailing Address - Phone:740-487-1241
Mailing Address - Fax:740-487-1253
Practice Address - Street 1:2052 EAST PIKE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-4621
Practice Address - Country:US
Practice Address - Phone:740-487-1241
Practice Address - Fax:740-487-1253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-02
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0252167Medicaid