Provider Demographics
NPI:1891701520
Name:FOX CHASE CANCER HOSPICE
Entity Type:Organization
Organization Name:FOX CHASE CANCER HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF HEALTH SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:PICCOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-728-6900
Mailing Address - Street 1:333 COTTMAN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-2434
Mailing Address - Country:US
Mailing Address - Phone:215-728-6900
Mailing Address - Fax:215-728-1023
Practice Address - Street 1:333 COTTMAN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-2434
Practice Address - Country:US
Practice Address - Phone:215-728-6900
Practice Address - Fax:215-728-1023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA012901284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007736990001Medicaid
PA1007736990001Medicaid