Provider Demographics
NPI:1689691404
Name:HOSPICE OF METROPOLITAN ERIE, INC.
Entity Type:Organization
Organization Name:HOSPICE OF METROPOLITAN ERIE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:C
Authorized Official - Last Name:MOSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-456-6689
Mailing Address - Street 1:202 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16503-1008
Mailing Address - Country:US
Mailing Address - Phone:814-456-6689
Mailing Address - Fax:814-456-8219
Practice Address - Street 1:202 E 10TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16503-1008
Practice Address - Country:US
Practice Address - Phone:814-456-6689
Practice Address - Fax:814-456-8219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA16731601251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1018088600001Medicaid
PA1018088600001Medicaid