Provider Demographics
NPI:1417997925
Name:DIGNITY HEALTH
Entity Type:Organization
Organization Name:DIGNITY HEALTH
Other - Org Name:MERCY HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BOB
Authorized Official - Middle Name:
Authorized Official - Last Name:PASCUZZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-537-5153
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:916-281-3900
Mailing Address - Fax:916-281-2396
Practice Address - Street 1:3400 DATA DR
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-7956
Practice Address - Country:US
Practice Address - Phone:916-281-3900
Practice Address - Fax:916-281-2396
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIGNITY HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-07
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100000775251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHPC01600GMedicaid
ZZZ22889ZOtherBLUE SHIELD OF CA
942761692OtherIRS - PRE-MERGER SP TIN
942761692OtherIRS - PRE-MERGER SP TIN