Provider Demographics
NPI:1255896833
Name:US UNIVERSAL HOSPICE INC
Entity type:Organization
Organization Name:US UNIVERSAL HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALTERNATE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:COLLINS
Authorized Official - Middle Name:
Authorized Official - Last Name:IYAMAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-420-2968
Mailing Address - Street 1:214 S MAIN ST STE 212
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-4768
Mailing Address - Country:US
Mailing Address - Phone:972-780-5226
Mailing Address - Fax:972-780-4793
Practice Address - Street 1:214 S MAIN ST STE 212
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4768
Practice Address - Country:US
Practice Address - Phone:972-780-5226
Practice Address - Fax:972-780-4793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based