Provider Demographics
NPI:1578018669
Name:PACIFIC VALLEY HOSPICE CARE INC
Entity Type:Organization
Organization Name:PACIFIC VALLEY HOSPICE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICKY
Authorized Official - Middle Name:
Authorized Official - Last Name:SWAMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-528-5748
Mailing Address - Street 1:813 N LA CADENA DR
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-2747
Mailing Address - Country:US
Mailing Address - Phone:818-528-5748
Mailing Address - Fax:818-783-2113
Practice Address - Street 1:813 N LA CADENA DR
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-2747
Practice Address - Country:US
Practice Address - Phone:818-528-5748
Practice Address - Fax:818-783-2113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-18
Last Update Date:2017-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based