Provider Demographics
NPI:1407069743
Name:PATHWAYS HOME HEALTH AND HOSPICE
Entity Type:Organization
Organization Name:PATHWAYS HOME HEALTH AND HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE & CFO
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-576-8478
Mailing Address - Street 1:585 N MARY AVE
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-2905
Mailing Address - Country:US
Mailing Address - Phone:408-773-4301
Mailing Address - Fax:
Practice Address - Street 1:585 N MARY AVE
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-2905
Practice Address - Country:US
Practice Address - Phone:408-730-5100
Practice Address - Fax:408-730-8726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA220000429251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA07190HMedicaid
CACA181928OtherMEDICARE PART B
057190Medicare PIN
CA057190Medicare ID - Type UnspecifiedHOME CARE NUMBER