Provider Demographics
NPI:1477978740
Name:SIMONE HOSPICE LLC
Entity Type:Organization
Organization Name:SIMONE HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VIENGKEO
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUNEMANY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-747-3356
Mailing Address - Street 1:750 E BROAD ST STE 300A
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-1126
Mailing Address - Country:US
Mailing Address - Phone:614-224-1347
Mailing Address - Fax:614-224-5396
Practice Address - Street 1:750 E BROAD ST STE 300A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-1126
Practice Address - Country:US
Practice Address - Phone:614-224-1347
Practice Address - Fax:614-224-5396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-24
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health