Provider Demographics
NPI:1417530817
Name:MISSOURI PALLIATIVE & HOSPICE CARE NORTHWEST LLC
Entity Type:Organization
Organization Name:MISSOURI PALLIATIVE & HOSPICE CARE NORTHWEST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-505-5934
Mailing Address - Street 1:3675 S NOLAND RD STE 215C
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-3369
Mailing Address - Country:US
Mailing Address - Phone:816-505-5934
Mailing Address - Fax:816-505-5935
Practice Address - Street 1:3675 S NOLAND RD STE 215C
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-3369
Practice Address - Country:US
Practice Address - Phone:816-505-5934
Practice Address - Fax:816-505-5935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-03
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based