Provider Demographics
NPI:1013467265
Name:AMAG HOSPICE, INC.
Entity Type:Organization
Organization Name:AMAG HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROUT
Authorized Official - Middle Name:
Authorized Official - Last Name:DZHIMBASHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-934-7755
Mailing Address - Street 1:1736 ERRINGER RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-3558
Mailing Address - Country:US
Mailing Address - Phone:818-934-7755
Mailing Address - Fax:888-512-1287
Practice Address - Street 1:1736 ERRINGER RD
Practice Address - Street 2:SUITE 106
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-3558
Practice Address - Country:US
Practice Address - Phone:818-934-7755
Practice Address - Fax:888-512-1287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-12
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based