Provider Demographics
NPI:1245987312
Name:CWM HOSPICE CARE 1, LLC
Entity type:Organization
Organization Name:CWM HOSPICE CARE 1, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MCARDLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-263-7987
Mailing Address - Street 1:540 E APPLEBY RD STE 104
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-4114
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4900 RICHMOND SQ STE 106
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-2043
Practice Address - Country:US
Practice Address - Phone:405-876-8083
Practice Address - Fax:405-876-8997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based