Provider Demographics
NPI:1265089841
Name:GAMMA HOSPICE, INC.
Entity type:Organization
Organization Name:GAMMA HOSPICE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:WERTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-205-0025
Mailing Address - Street 1:11100 VALLEY BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-2533
Mailing Address - Country:US
Mailing Address - Phone:747-205-0025
Mailing Address - Fax:747-205-0031
Practice Address - Street 1:11100 VALLEY BLVD STE 106
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-2533
Practice Address - Country:US
Practice Address - Phone:747-205-0025
Practice Address - Fax:747-205-0031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-20
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based