Provider Demographics
NPI:1497816839
Name:RURAL HOSPICE,INC.
Entity Type:Organization
Organization Name:RURAL HOSPICE,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:432-558-2300
Mailing Address - Street 1:PO BOX 1176
Mailing Address - Street 2:
Mailing Address - City:CRANE
Mailing Address - State:TX
Mailing Address - Zip Code:79731-1176
Mailing Address - Country:US
Mailing Address - Phone:432-558-2300
Mailing Address - Fax:432-558-2335
Practice Address - Street 1:204 W 5TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:CRANE
Practice Address - State:TX
Practice Address - Zip Code:79731-2510
Practice Address - Country:US
Practice Address - Phone:432-558-2300
Practice Address - Fax:432-558-2335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX004364251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2157Medicaid
TX2157Medicaid