Provider Demographics
NPI:1821422312
Name:BVA HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:BVA HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-550-9950
Mailing Address - Street 1:315 ARDEN AVE SUITE 25
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-3150
Mailing Address - Country:US
Mailing Address - Phone:818-550-9950
Mailing Address - Fax:818-550-9953
Practice Address - Street 1:315 ARDEN AVE SUITE 25
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-3150
Practice Address - Country:US
Practice Address - Phone:818-550-9950
Practice Address - Fax:818-550-9953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-03
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
751707OtherMEDICARE CCN