Provider Demographics
NPI:1568136380
Name:FIDELITY HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:FIDELITY HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKHTAMYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-345-3062
Mailing Address - Street 1:4854 VAN NUYS BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2114
Mailing Address - Country:US
Mailing Address - Phone:747-345-3062
Mailing Address - Fax:747-345-3063
Practice Address - Street 1:4854 VAN NUYS BLVD STE 210
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-2114
Practice Address - Country:US
Practice Address - Phone:747-345-3062
Practice Address - Fax:747-345-3063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-04
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based