Provider Demographics
NPI:1558079566
Name:ANCORA HOSPICE & PALLIATIVE SERVICES, LLC
Entity Type:Organization
Organization Name:ANCORA HOSPICE & PALLIATIVE SERVICES, LLC
Other - Org Name:ANCORA HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GALLIGAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-452-2672
Mailing Address - Street 1:808 N WHITLEY DR
Mailing Address - Street 2:
Mailing Address - City:FRUITLAND
Mailing Address - State:ID
Mailing Address - Zip Code:83619-2437
Mailing Address - Country:US
Mailing Address - Phone:208-452-2672
Mailing Address - Fax:
Practice Address - Street 1:808 N WHITLEY DR
Practice Address - Street 2:
Practice Address - City:FRUITLAND
Practice Address - State:ID
Practice Address - Zip Code:83619-2437
Practice Address - Country:US
Practice Address - Phone:208-452-2672
Practice Address - Fax:208-452-2673
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANCORA HOSPICE & PALLIATIVE SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-08
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty