Provider Demographics
NPI:1619219714
Name:FRONTIER HOME HEALTH AND HOSPICE, LLC
Entity Type:Organization
Organization Name:FRONTIER HOME HEALTH AND HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:B
Authorized Official - Last Name:GESSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-693-3840
Mailing Address - Street 1:53 RIVER ST
Mailing Address - Street 2:YANKEE PROFESSIONAL BUILDING
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3346
Mailing Address - Country:US
Mailing Address - Phone:203-693-3840
Mailing Address - Fax:203-693-3841
Practice Address - Street 1:800 JASMINE ST
Practice Address - Street 2:SUITE 3
Practice Address - City:OMAK
Practice Address - State:WA
Practice Address - Zip Code:98841-9501
Practice Address - Country:US
Practice Address - Phone:509-422-8621
Practice Address - Fax:509-422-0131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-27
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60077040251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1619219714Medicaid
WA1619219714Medicaid