Provider Demographics
NPI:1144802497
Name:PURE GOLDEN HOSPICE INC
Entity Type:Organization
Organization Name:PURE GOLDEN HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RUSTAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HAKOBYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-799-9099
Mailing Address - Street 1:21405 DEVONSHIRE ST STE 215A
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-2941
Mailing Address - Country:US
Mailing Address - Phone:844-799-9099
Mailing Address - Fax:
Practice Address - Street 1:21405 DEVONSHIRE ST STE 215A
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-2941
Practice Address - Country:US
Practice Address - Phone:844-799-9099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based