Provider Demographics
NPI:1326620386
Name:HOSPICE OF THE MIDWEST, LLC
Entity Type:Organization
Organization Name:HOSPICE OF THE MIDWEST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSLOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-576-0087
Mailing Address - Street 1:11606 NICHOLAS ST STE 700
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-4486
Mailing Address - Country:US
Mailing Address - Phone:402-819-1947
Mailing Address - Fax:402-819-6872
Practice Address - Street 1:11606 NICHOLAS ST STE 700
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-4486
Practice Address - Country:US
Practice Address - Phone:402-819-1947
Practice Address - Fax:402-819-6872
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOSPICE OF THE MIDWEST, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based