Provider Demographics
NPI:1548201957
Name:HOSPICE OF WARREN COUNTY
Entity Type:Organization
Organization Name:HOSPICE OF WARREN COUNTY
Other - Org Name:HOSPICE OF WARREN COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULTZJOHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-723-2455
Mailing Address - Street 1:1 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:PA
Mailing Address - Zip Code:16365-2116
Mailing Address - Country:US
Mailing Address - Phone:814-723-2455
Mailing Address - Fax:814-723-6259
Practice Address - Street 1:1 MAIN AVE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:PA
Practice Address - Zip Code:16365-2116
Practice Address - Country:US
Practice Address - Phone:814-723-2455
Practice Address - Fax:814-723-6259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2278P3800X, 251G00000X
PA155199251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community Based
No2278P3800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedPalliative/HospiceGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007513230004Medicaid
PA1007513230001Medicaid