Provider Demographics
NPI:1205049558
Name:PATHWAYS HOME HEALTH AND HOSPICE
Entity type:Organization
Organization Name:PATHWAYS HOME HEALTH AND HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P. FINANCE & CFO
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-576-8478
Mailing Address - Street 1:585 N MARY AVE
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-2905
Mailing Address - Country:US
Mailing Address - Phone:408-730-1500
Mailing Address - Fax:408-730-8716
Practice Address - Street 1:1050 MARINA VILLAGE PKWY STE 105
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-1099
Practice Address - Country:US
Practice Address - Phone:510-632-4390
Practice Address - Fax:510-632-3334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA070000565251G00000X
251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHPC01506HMedicaid
CACA181927OtherMEDICARE PART B
CAHPC01506HMedicaid
051506Medicare PIN