Provider Demographics
NPI:1619918679
Name:HOSPICE OF RENO COUNTY, INC.
Entity Type:Organization
Organization Name:HOSPICE OF RENO COUNTY, INC.
Other - Org Name:HOSPICE OF RENO COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, CHPN
Authorized Official - Phone:620-665-2473
Mailing Address - Street 1:2020 N WALDRON ST STE 100
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-1100
Mailing Address - Country:US
Mailing Address - Phone:620-665-2473
Mailing Address - Fax:620-669-5959
Practice Address - Street 1:2020 N WALDRON ST STE 100
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-1100
Practice Address - Country:US
Practice Address - Phone:620-665-2473
Practice Address - Fax:620-669-5959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS00833OtherBCBS
KS100221080BMedicaid