Provider Demographics
NPI:1942502976
Name:SUPREME HOSPICE AND PALLIATIVE CARE, INC.
Entity Type:Organization
Organization Name:SUPREME HOSPICE AND PALLIATIVE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:OZEROVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-281-0070
Mailing Address - Street 1:9028 W SUNSET BLVD
Mailing Address - Street 2:SUITE 309A
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-1846
Mailing Address - Country:US
Mailing Address - Phone:310-281-0070
Mailing Address - Fax:310-438-7823
Practice Address - Street 1:9028 W SUNSET BLVD
Practice Address - Street 2:SUITE 309A
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90069-1846
Practice Address - Country:US
Practice Address - Phone:310-281-0070
Practice Address - Fax:310-438-7823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-24
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health