Provider Demographics
NPI:1689943763
Name:AURORA HOSPICE INC
Entity Type:Organization
Organization Name:AURORA HOSPICE INC
Other - Org Name:AURORA HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUS ADMIN
Authorized Official - Prefix:MS
Authorized Official - First Name:ELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEYSHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-242-0077
Mailing Address - Street 1:524 BUSTLETON PIKE
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-6069
Mailing Address - Country:US
Mailing Address - Phone:215-396-8822
Mailing Address - Fax:215-396-8447
Practice Address - Street 1:524 BUSTLETON PIKE
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6069
Practice Address - Country:US
Practice Address - Phone:215-396-8822
Practice Address - Fax:215-396-8447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-20
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA17381601251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1028776290001Medicaid