EUREKA SPRINGS HOSPITAL HOSPICE LLC NPI 1417084765

NPI Information

NPI: 1417084765
Provider Name: EUREKA SPRINGS HOSPITAL HOSPICE, LLC

Doing Business As: ELITE HOSPICE

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

Address:
4847 KAYLEE AVE STE A
SPRINGDALE, AR
ZIP 72762
Phone: (479) 751-3019
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EUREKA SPRINGS HOSPITAL HOSPICE, LLC is a hospice care community based in Springdale, AR. EUREKA SPRINGS HOSPITAL HOSPICE, LLC NPI is 1417084765. The provider is registered as an organization entity type.
The provider Is Doing Business As Elite Hospice.

The provider's business location address is:

4847 KAYLEE AVE STE A
SPRINGDALE, AR
ZIP 72762-871
Phone: (479) 751-3019
Fax: (479) 750-2710

The provider's authorized official is Joshua L Proffitt .
The authorized official title is President and has the following contact phone number (337) 233-1307.

The CLIA number assigned to this NPI record is 04D1068195 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/27/2007 and was last updated on 2/13/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251G00000X	Hospice Care, Community Based		AR4472	ARKANSAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	167373747	MEDICAID	ARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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