Provider Demographics
NPI:1932296126
Name:THI OF TEXAS AT SAMARITAN HOSPICE, LLC
Entity Type:Organization
Organization Name:THI OF TEXAS AT SAMARITAN HOSPICE, LLC
Other - Org Name:SAMARITAN CARE HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-425-5407
Mailing Address - Street 1:12 CADILLAC DR
Mailing Address - Street 2:SUITE 360
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5272
Mailing Address - Country:US
Mailing Address - Phone:615-425-5407
Mailing Address - Fax:615-373-4457
Practice Address - Street 1:7001 GRAPEVINE HWY
Practice Address - Street 2:SUITE 500
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-8811
Practice Address - Country:US
Practice Address - Phone:817-590-9623
Practice Address - Fax:817-590-1603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-07
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001012167Medicaid
451629Medicare Oscar/Certification