Provider Demographics
NPI:1720687627
Name:ROSA BLUE HOSPICE, INC
Entity Type:Organization
Organization Name:ROSA BLUE HOSPICE, INC
Other - Org Name:ROSA BLUE HOSPICE . INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ADWOA SERWA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSEI NYARKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-707-9696
Mailing Address - Street 1:6400 E WASHINGTON BLVD # 101
Mailing Address - Street 2:
Mailing Address - City:COMMERCE
Mailing Address - State:CA
Mailing Address - Zip Code:90040-1820
Mailing Address - Country:US
Mailing Address - Phone:877-707-9696
Mailing Address - Fax:
Practice Address - Street 1:6400 E WASHINGTON BLVD # 101
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:CA
Practice Address - Zip Code:90040-1820
Practice Address - Country:US
Practice Address - Phone:877-707-9696
Practice Address - Fax:877-771-9227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251B00000XAgenciesCase Management
No251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies