Provider Demographics
NPI:1518363845
Name:SOUTH PLAINS HEALTHCARE, INC.
Entity Type:Organization
Organization Name:SOUTH PLAINS HEALTHCARE, INC.
Other - Org Name:HOSPICE OF THE SOUTH PLAINS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-401-1369
Mailing Address - Street 1:4413 82ND ST
Mailing Address - Street 2:SUITE 135
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-3384
Mailing Address - Country:US
Mailing Address - Phone:806-747-9484
Mailing Address - Fax:806-747-9497
Practice Address - Street 1:4413 82ND ST
Practice Address - Street 2:SUITE 135
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-3384
Practice Address - Country:US
Practice Address - Phone:806-747-9484
Practice Address - Fax:806-747-9497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-13
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
671667Medicare Oscar/Certification