Provider Demographics
NPI:1295034270
Name:STUDIO CITY HOSPICE INC
Entity Type:Organization
Organization Name:STUDIO CITY HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MIDURYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-505-0019
Mailing Address - Street 1:12500 RIVERSIDE DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91607-3423
Mailing Address - Country:US
Mailing Address - Phone:818-505-0019
Mailing Address - Fax:
Practice Address - Street 1:12500 RIVERSIDE DR
Practice Address - Street 2:SUITE 205
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91607-3423
Practice Address - Country:US
Practice Address - Phone:818-505-0019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-16
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based