BEACON HOSPICE LLC NPI 1043335011

NPI Information

NPI: 1043335011
Provider Name: BEACON HOSPICE, LLC
Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

CLIA Number: 22D0677966

Address:
200 NICKERSON RD STE 110
MARLBOROUGH, MA
ZIP 01752
Phone: (508) 266-8290
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BEACON HOSPICE, LLC is a hospice care community based in Marlborough, MA. BEACON HOSPICE, LLC NPI is 1043335011. The provider is registered as an organization entity type.

The provider's business location address is:

200 NICKERSON RD STE 110
MARLBOROUGH, MA
ZIP 01752-641
Phone: (508) 266-8290
Fax: (508) 229-3127

The provider's authorized official is Paul Kusserow .
The authorized official title is President/ceo and has the following contact phone number (225) 292-2031.

The CLIA number assigned to this NPI record is 22D0677966 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/20/2007 and was last updated on 12/12/2017.

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		75ML	MASSACHUSETTS	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	0600113	MEDICAID	MASSACHUSETTS
2	PENDING	MEDICAID	MASSACHUSETTS

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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