Provider Demographics
NPI:1346941275
Name:FRONTIDA HOSPICE CARE LLC
Entity Type:Organization
Organization Name:FRONTIDA HOSPICE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADEWALE
Authorized Official - Middle Name:
Authorized Official - Last Name:ODUKOYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-559-7455
Mailing Address - Street 1:3609 SMITH BARRY RD STE 106
Mailing Address - Street 2:
Mailing Address - City:PANTEGO
Mailing Address - State:TX
Mailing Address - Zip Code:76013-4631
Mailing Address - Country:US
Mailing Address - Phone:909-559-7455
Mailing Address - Fax:
Practice Address - Street 1:3609 SMITH BARRY RD STE 106
Practice Address - Street 2:
Practice Address - City:PANTEGO
Practice Address - State:TX
Practice Address - Zip Code:76013-4631
Practice Address - Country:US
Practice Address - Phone:909-559-7455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based