Provider Demographics
NPI:1407032394
Name:MILESTONE HOSPICE
Entity Type:Organization
Organization Name:MILESTONE HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCNAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-782-1177
Mailing Address - Street 1:1321 W CARSON ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-3964
Mailing Address - Country:US
Mailing Address - Phone:310-782-1177
Mailing Address - Fax:
Practice Address - Street 1:1321 W CARSON ST
Practice Address - Street 2:SUITE 5
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-3964
Practice Address - Country:US
Practice Address - Phone:310-782-1177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA051718Medicare Oscar/Certification