Provider Demographics
NPI:1235189440
Name:HOSPICE OF MARION COUNTY INC
Entity Type:Organization
Organization Name:HOSPICE OF MARION COUNTY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:BOURNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-873-7400
Mailing Address - Street 1:PO BOX 4860
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34478-4860
Mailing Address - Country:US
Mailing Address - Phone:352-873-7400
Mailing Address - Fax:352-873-7435
Practice Address - Street 1:3231 SW 34TH AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-8489
Practice Address - Country:US
Practice Address - Phone:352-873-7400
Practice Address - Fax:352-873-7435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5020096251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL087520100Medicaid
FL118680000Medicaid