Provider Demographics
NPI:1073925533
Name:GALAXY HOSPICE, INC
Entity Type:Organization
Organization Name:GALAXY HOSPICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALPHIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DE GUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-364-5158
Mailing Address - Street 1:4055 SPENCER ST
Mailing Address - Street 2:STE 217
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-9303
Mailing Address - Country:US
Mailing Address - Phone:702-988-6789
Mailing Address - Fax:702-988-8813
Practice Address - Street 1:4055 SPENCER ST
Practice Address - Street 2:STE 217
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-9303
Practice Address - Country:US
Practice Address - Phone:702-988-6789
Practice Address - Fax:702-988-8813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-02
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7765HPC-0251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based