Provider Demographics
NPI:1700881703
Name:HOPE HOSPICE INC
Entity Type:Organization
Organization Name:HOPE HOSPICE INC
Other - Org Name:HOPE HOSPICE OF FULTON COUNTY
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:PURKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-224-4673
Mailing Address - Street 1:PO BOX 621
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:IN
Mailing Address - Zip Code:46975-0621
Mailing Address - Country:US
Mailing Address - Phone:574-224-4673
Mailing Address - Fax:574-224-4444
Practice Address - Street 1:1476 W 18TH ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:IN
Practice Address - Zip Code:46975-7939
Practice Address - Country:US
Practice Address - Phone:574-224-4673
Practice Address - Fax:574-224-4444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-16
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN050098781251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200145090AMedicaid
IN151562Medicare Oscar/Certification