365 Hospice, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

365 HOSPICE, LLC

Practice address

355 N 21St St Ste 207
Camp Hill, PA 17011-3707

Phone

(717) 730-6734

Fax

(717) 730-6735

NPI assigned

Jan 19, 2009

Last updated

Mar 17, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jonathan C Rezk

Title

Cfo

Phone

(814) 419-4901

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1232323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1942447529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 S MAIN ST",
            "city": "CARROLLTOWN",
            "state": "PA",
            "postal_code": "157220477",
            "telephone_number": "814-419-4901",
            "fax_number": "814-419-4902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 N 21ST ST STE 207",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170113707",
            "telephone_number": "717-730-6734",
            "fax_number": "717-730-6735"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Camp Hill Byp",
            "address_2": "SUITE 201",
            "address_purpose": "LOCATION",
            "city": "Camp Hill",
            "state": "PA",
            "postal_code": "170113700",
            "country_code": "US",
            "telephone_number": "717-730-6734",
            "fax_number": "717-730-6735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "365 HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-19",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "REZK",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "814-419-4901"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020513330004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.