Provider Demographics
NPI:1659310514
Name:HOSPICE PREFERRED CHOICE, INC.
Entity Type:Organization
Organization Name:HOSPICE PREFERRED CHOICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:RASMUSSEN-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-201-4835
Mailing Address - Street 1:1000 FIANNA WAY
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72919-9008
Mailing Address - Country:US
Mailing Address - Phone:877-823-8375
Mailing Address - Fax:
Practice Address - Street 1:1117 PERIMETER CENTER WEST
Practice Address - Street 2:N500
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-5451
Practice Address - Country:US
Practice Address - Phone:770-698-8785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOMECARE PREFERRED CHOICE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-06
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAMCD00779358AMedicaid
GAMCD00779358AMedicaid