Provider Demographics
NPI:1669645479
Name:EAST COAST HOSPICE, INC.
Entity Type:Organization
Organization Name:EAST COAST HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:CANLAS
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-229-5899
Mailing Address - Street 1:26 BERNARD ST
Mailing Address - Street 2:NO.90
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93305-3493
Mailing Address - Country:US
Mailing Address - Phone:661-324-1700
Mailing Address - Fax:661-324-1177
Practice Address - Street 1:26 BERNARD ST
Practice Address - Street 2:NO.90
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-3493
Practice Address - Country:US
Practice Address - Phone:661-324-1700
Practice Address - Fax:661-324-1177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-12
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based