Provider Demographics
NPI:1578653267
Name:HOSPICE OF KNOX COUNTY
Entity Type:Organization
Organization Name:HOSPICE OF KNOX COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM EXECUTIVE DIRECTORY
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TUTTLE
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN, MSA
Authorized Official - Phone:740-397-5188
Mailing Address - Street 1:17700 COSHOCTON RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-9218
Mailing Address - Country:US
Mailing Address - Phone:740-397-5188
Mailing Address - Fax:740-397-5189
Practice Address - Street 1:17700 COSHOCTON RD
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-9218
Practice Address - Country:US
Practice Address - Phone:740-397-5188
Practice Address - Fax:740-397-5189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0826959Medicaid
OH000000156775OtherANTHEM
OH000000156775OtherANTHEM