Provider Demographics
NPI:1184925562
Name:HORIZONS HOSPICE, LLC
Entity type:Organization
Organization Name:HORIZONS HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P. OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:REZK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-946-5017
Mailing Address - Street 1:119 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARROLLTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15722-0477
Mailing Address - Country:US
Mailing Address - Phone:814-419-4901
Mailing Address - Fax:814-419-4902
Practice Address - Street 1:3228 W CARY ST
Practice Address - Street 2:SUITE B
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23221-3400
Practice Address - Country:US
Practice Address - Phone:804-353-2702
Practice Address - Fax:804-353-2719
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HORIZONS HOSPICE,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-16
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA491602Medicare Oscar/Certification