Provider Demographics
NPI:1831525104
Name:ST SARKIS HOSPICE, INC.
Entity type:Organization
Organization Name:ST SARKIS HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-588-5803
Mailing Address - Street 1:620 W ROUTE 66
Mailing Address - Street 2:STE 214
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-4105
Mailing Address - Country:US
Mailing Address - Phone:818-588-5803
Mailing Address - Fax:
Practice Address - Street 1:620 W ROUTE 66
Practice Address - Street 2:STE 214
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-4105
Practice Address - Country:US
Practice Address - Phone:818-588-5803
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based