Provider Demographics
NPI:1023627916
Name:PEGASUS HOSPICE, INC
Entity type:Organization
Organization Name:PEGASUS HOSPICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HOVIK
Authorized Official - Middle Name:
Authorized Official - Last Name:SEYSYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-504-8049
Mailing Address - Street 1:8111 SAN FERNANDO RD
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-4005
Mailing Address - Country:US
Mailing Address - Phone:818-504-8049
Mailing Address - Fax:
Practice Address - Street 1:8111 SAN FERNANDO RD
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-4005
Practice Address - Country:US
Practice Address - Phone:818-504-8049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based