Provider Demographics
NPI:1760882963
Name:CHS HOSPICE & PALLIATIVE CARE SERVICES LLC
Entity Type:Organization
Organization Name:CHS HOSPICE & PALLIATIVE CARE SERVICES LLC
Other - Org Name:BUCKEYE HOSPICE AND PALLIATIVE CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PARSON
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:216-772-3192
Mailing Address - Street 1:5990 VENTURE DR.
Mailing Address - Street 2:SUITE A
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017
Mailing Address - Country:US
Mailing Address - Phone:740-281-2243
Mailing Address - Fax:740-616-8017
Practice Address - Street 1:856 S. RIVERSIDE DRIVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MCCONNELLSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43756-9102
Practice Address - Country:US
Practice Address - Phone:740-281-2243
Practice Address - Fax:740-616-8017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-26
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RH0002X, 251G00000X, 315D00000X
OH315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community Based
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0143815Medicaid