Provider Demographics
NPI:1730293614
Name:PREFERRED HOSPICE INC.
Entity Type:Organization
Organization Name:PREFERRED HOSPICE INC.
Other - Org Name:LEGACY HOSPICE & PALLIATIVE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMMIE
Authorized Official - Middle Name:SHELTON
Authorized Official - Last Name:VENCILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-596-9181
Mailing Address - Street 1:1963 2ND ST
Mailing Address - Street 2:
Mailing Address - City:RICHLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:24641-2303
Mailing Address - Country:US
Mailing Address - Phone:276-596-9181
Mailing Address - Fax:276-596-9182
Practice Address - Street 1:1963 2ND ST
Practice Address - Street 2:
Practice Address - City:RICHLANDS
Practice Address - State:VA
Practice Address - Zip Code:24641-2303
Practice Address - Country:US
Practice Address - Phone:276-596-9181
Practice Address - Fax:276-596-9182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010147565Medicaid