Provider Demographics
NPI:1982686192
Name:HOSPICE OF EL PASO INC.
Entity Type:Organization
Organization Name:HOSPICE OF EL PASO INC.
Other - Org Name:HOSPICE EL PASO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-532-5699
Mailing Address - Street 1:1440 MIRACLE WAY
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-7102
Mailing Address - Country:US
Mailing Address - Phone:915-532-5699
Mailing Address - Fax:915-532-7822
Practice Address - Street 1:1440 MIRACLE WAY
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-7102
Practice Address - Country:US
Practice Address - Phone:915-532-5699
Practice Address - Fax:915-532-7822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-15
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX003133251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000200200Medicaid
451505Medicare UPIN
TX451505Medicare UPIN
TX451505Medicare PIN