Provider Demographics
NPI:1013928670
Name:HOPE HOSPICE, LLC
Entity Type:Organization
Organization Name:HOPE HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:CROCKETT
Authorized Official - Suffix:
Authorized Official - Credentials:LPN, BA
Authorized Official - Phone:918-333-7700
Mailing Address - Street 1:3414 SE KENTUCKY
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-2319
Mailing Address - Country:US
Mailing Address - Phone:918-333-7700
Mailing Address - Fax:918-333-8200
Practice Address - Street 1:3414 SE KENTUCKY ST
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-2319
Practice Address - Country:US
Practice Address - Phone:918-333-7700
Practice Address - Fax:918-333-8200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4145251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK371603Medicare ID - Type Unspecified