Provider Demographics
NPI:1083377154
Name:PRIORITY MM CARE HOSPICE INC
Entity Type:Organization
Organization Name:PRIORITY MM CARE HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GAMBARINI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:181-843-4241
Mailing Address - Street 1:301 S 6TH ST APT C
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91501-2328
Mailing Address - Country:US
Mailing Address - Phone:181-843-4241
Mailing Address - Fax:818-614-5903
Practice Address - Street 1:14617 VICTORY BLVD STE 4
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-1675
Practice Address - Country:US
Practice Address - Phone:818-697-2756
Practice Address - Fax:818-614-5903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-15
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based