Provider Demographics
NPI:1659301539
Name:HCA ACQUISITION HOLDINGS INC
Entity Type:Organization
Organization Name:HCA ACQUISITION HOLDINGS INC
Other - Org Name:ST CROIX HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HEATH
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARTNESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-735-3656
Mailing Address - Street 1:185 BUCKLEY DR STE B
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-5806
Mailing Address - Country:US
Mailing Address - Phone:815-316-2700
Mailing Address - Fax:815-316-2702
Practice Address - Street 1:185 BUCKLEY DR STE B
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-5806
Practice Address - Country:US
Practice Address - Phone:815-316-2700
Practice Address - Fax:815-316-2702
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HCA ACQUISITION HOLDINGS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-04
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1712953251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL201126616001Medicaid
IL=========001Medicaid