Provider Demographics
NPI:1518237619
Name:ETERNAL HOSPICE CARE INC.
Entity Type:Organization
Organization Name:ETERNAL HOSPICE CARE INC.
Other - Org Name:TRANQUIL OAKS HOSPICE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:MARANAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-727-6314
Mailing Address - Street 1:2155 E GARVEY AVE N STE B10
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-1509
Mailing Address - Country:US
Mailing Address - Phone:626-727-6314
Mailing Address - Fax:626-727-6316
Practice Address - Street 1:2155 E GARVEY AVE N STE B10
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791-1509
Practice Address - Country:US
Practice Address - Phone:626-727-6314
Practice Address - Fax:626-727-6316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-05
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA75-1572Medicare PIN