Provider Demographics
NPI:1760599070
Name:CWM HOSPICE CARE 2, LLC
Entity Type:Organization
Organization Name:CWM HOSPICE CARE 2, LLC
Other - Org Name:TRINITY HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MCARDLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-594-9990
Mailing Address - Street 1:540 E APPLEBY RD STE 104
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-4114
Mailing Address - Country:US
Mailing Address - Phone:405-594-9990
Mailing Address - Fax:405-594-9994
Practice Address - Street 1:201 NW 63RD ST STE 230
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-8232
Practice Address - Country:US
Practice Address - Phone:055-949-9904
Practice Address - Fax:095-949-9944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4192251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK371646Medicare ID - Type UnspecifiedLEGACY PROVIDER NUMBER