Organization
HOSPICE
Active
Other names
Hospice of Davis & Wapello Counties
Organization subpart
No
Provider details
NPI number
Authorized official
SUZANNE M ANDERSON (EXECUTIVE DIRECTOR)
(641) 682-0684
Entity
Organization
Contact information
Practice address
927 PENNSYLVANIA AVE, OTTUMWA, IA 52501-2138
(641) 682-0684
(641) 684-9209
Mailing address
PO BOX 1150, OTTUMWA, IA 52501-7150
(641) 682-0684
(641) 684-9209
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
315D00000X
Inpatient Hospice
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0615138
—
IA
01
—
61513
WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA
IA
Enumeration date
06/09/2005
Last updated
12/09/2009
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