Provider Demographics
NPI:1073277257
Name:AEVUM HOSPICE INC.
Entity Type:Organization
Organization Name:AEVUM HOSPICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ZOLTAN
Authorized Official - Middle Name:CRISITAN
Authorized Official - Last Name:SOO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-709-2232
Mailing Address - Street 1:461B HILL ST
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-2325
Mailing Address - Country:US
Mailing Address - Phone:805-709-2242
Mailing Address - Fax:805-586-3427
Practice Address - Street 1:461B HILL ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-2325
Practice Address - Country:US
Practice Address - Phone:805-709-2242
Practice Address - Fax:805-586-3427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based