Provider Demographics
NPI:1629045059
Name:HOSPICE OF CRAWFORD COUNTY INC
Entity Type:Organization
Organization Name:HOSPICE OF CRAWFORD COUNTY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMI
Authorized Official - Middle Name:L
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:MHA, BSN, RN, CPHQ
Authorized Official - Phone:814-333-5583
Mailing Address - Street 1:766 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-2555
Mailing Address - Country:US
Mailing Address - Phone:814-333-5403
Mailing Address - Fax:814-333-5407
Practice Address - Street 1:766 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-2555
Practice Address - Country:US
Practice Address - Phone:814-333-5403
Practice Address - Fax:814-333-5407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-03
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001179904Medicaid
PA001179904Medicaid