Provider Demographics
NPI:1245714211
Name:AMICH HOSPICE, INC.
Entity type:Organization
Organization Name:AMICH HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:PRISCILLA
Authorized Official - Last Name:MUSOH NGUMA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:651-332-4465
Mailing Address - Street 1:9950 WESTPARK DR STE 644
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-5199
Mailing Address - Country:US
Mailing Address - Phone:651-332-4465
Mailing Address - Fax:281-564-7326
Practice Address - Street 1:9950 WESTPARK DR STE 644
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-5199
Practice Address - Country:US
Practice Address - Phone:651-332-4465
Practice Address - Fax:281-564-7326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based