Provider Demographics
NPI:1497011571
Name:EVERCARE HOSPICE, INC.
Entity Type:Organization
Organization Name:EVERCARE HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:O
Authorized Official - Last Name:ENDERLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-221-0793
Mailing Address - Street 1:9900 BREN RD E STE 100
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55343-9664
Mailing Address - Country:US
Mailing Address - Phone:303-714-2377
Mailing Address - Fax:303-714-2396
Practice Address - Street 1:700 AMERICAN AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-4031
Practice Address - Country:US
Practice Address - Phone:610-265-2066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-03
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA391695Medicare PIN