Provider Demographics
NPI:1104854298
Name:MOGUL CORPORATION
Entity Type:Organization
Organization Name:MOGUL CORPORATION
Other - Org Name:SHANGRILA HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:PINUELA
Authorized Official - Last Name:BARRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-981-4065
Mailing Address - Street 1:1126 W. FOOTHILL BLVD.
Mailing Address - Street 2:SUITE #220
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-3777
Mailing Address - Country:US
Mailing Address - Phone:909-981-4065
Mailing Address - Fax:909-949-8460
Practice Address - Street 1:1126 W FOOTHILL BLVD
Practice Address - Street 2:SUITE #235
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3768
Practice Address - Country:US
Practice Address - Phone:909-981-4065
Practice Address - Fax:909-949-8460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based