- Enrollment id
- O20250923001403
- Enrollment state
- KY
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1093491904
- Multiple npi flag
- N
- Ccn
- 181527
- Associate id
- 4981795143
- Organization name
- HOSPARUS INC
- Doing business as name
- HOSPARUS WESTERN KENTUCKY
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 200 CLINIC DRIVE
- City
- MADISONVILLE
- State
- KY
- Zip code
- 424311661