Provider Demographics
NPI:1194389007
Name:PRIME CARE HOSPICE INC
Entity Type:Organization
Organization Name:PRIME CARE HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ELZA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIROSYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-937-2666
Mailing Address - Street 1:1540 W GLENOAKS BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-3162
Mailing Address - Country:US
Mailing Address - Phone:818-937-2666
Mailing Address - Fax:818-937-2667
Practice Address - Street 1:1540 W GLENOAKS BLVD STE 203
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201-3162
Practice Address - Country:US
Practice Address - Phone:818-937-2666
Practice Address - Fax:818-937-2667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-25
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based