Provider Demographics
NPI:1770333890
Name:PROVIDERS CHOICE HOSPICE INC
Entity type:Organization
Organization Name:PROVIDERS CHOICE HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:VELASCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-497-1949
Mailing Address - Street 1:237 W BONITA AVE STE E
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-3048
Mailing Address - Country:US
Mailing Address - Phone:909-572-5777
Mailing Address - Fax:909-572-8877
Practice Address - Street 1:237 W BONITA AVE STE E
Practice Address - Street 2:
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-3048
Practice Address - Country:US
Practice Address - Phone:909-572-5777
Practice Address - Fax:909-572-8877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based