Provider Demographics
NPI:1225610215
Name:S&D HOSPICE
Entity Type:Organization
Organization Name:S&D HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVIT
Authorized Official - Middle Name:
Authorized Official - Last Name:HOVHANNISYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-895-5200
Mailing Address - Street 1:2500 E FOOTHILL BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-7127
Mailing Address - Country:US
Mailing Address - Phone:747-895-5200
Mailing Address - Fax:
Practice Address - Street 1:2500 E FOOTHILL BLVD STE 202
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-7127
Practice Address - Country:US
Practice Address - Phone:747-895-5200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based