Provider Demographics
NPI:1427361633
Name:HOSPICE OF THURSTON. INC.
Entity Type:Organization
Organization Name:HOSPICE OF THURSTON. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THEO
Authorized Official - Middle Name:
Authorized Official - Last Name:OMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-651-7841
Mailing Address - Street 1:307 N FRANKS AVE
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:MI
Mailing Address - Zip Code:49091-1277
Mailing Address - Country:US
Mailing Address - Phone:269-651-7841
Mailing Address - Fax:269-651-2050
Practice Address - Street 1:307 N FRANKS AVE
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:MI
Practice Address - Zip Code:49091-1277
Practice Address - Country:US
Practice Address - Phone:269-651-7841
Practice Address - Fax:269-651-2050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-16
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based