HOSPICE OF JACKSON COUNTYINC NPI 1609873769

NPI Information

NPI: 1609873769
Provider Name: HOSPICE OF JACKSON COUNTY,INC
Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

CLIA Number: 16D1089737

Address:
611 W QUARRY ST
MAQUOKETA, IA
ZIP 52060
Phone: (563) 652-0123
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HOSPICE OF JACKSON COUNTY,INC is a hospice care community based in Maquoketa, IA. HOSPICE OF JACKSON COUNTY,INC NPI is 1609873769. The provider is registered as an organization entity type.

The provider's business location address is:

611 W QUARRY ST
MAQUOKETA, IA
ZIP 52060-125
Phone: (563) 652-0123
Fax: (563) 652-2181

The provider's authorized official is Rae Ann Thede .
The authorized official title is Director and has the following contact phone number (563) 652-0123.

The CLIA number assigned to this NPI record is 16D1089737 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/5/2005 and was last updated on 12/13/2022.

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				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	0615765	MEDICAID	IOWA

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: 5/5/2024

NPI Synchronization or Removal

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