Provider Demographics
NPI:1689968471
Name:626 HOSPICE, INC.
Entity Type:Organization
Organization Name:626 HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PETROS
Authorized Official - Middle Name:P
Authorized Official - Last Name:POGOSYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-790-8888
Mailing Address - Street 1:1409 FOOTHILL BLVD
Mailing Address - Street 2:200A
Mailing Address - City:LA CANADA FLINTRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91011-4300
Mailing Address - Country:US
Mailing Address - Phone:818-790-8888
Mailing Address - Fax:818-790-5555
Practice Address - Street 1:1409 FOOTHILL BLVD
Practice Address - Street 2:200A
Practice Address - City:LA CANADA
Practice Address - State:CA
Practice Address - Zip Code:91011-4300
Practice Address - Country:US
Practice Address - Phone:818-790-8888
Practice Address - Fax:818-790-5555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-08
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based