Provider Demographics
NPI:1881909992
Name:PRECISION HOSPICE AND PALLIATIVE CARE CORP.
Entity type:Organization
Organization Name:PRECISION HOSPICE AND PALLIATIVE CARE CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMVEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VARDUMYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-545-0746
Mailing Address - Street 1:210 N CENTRAL AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-2536
Mailing Address - Country:US
Mailing Address - Phone:818-545-0746
Mailing Address - Fax:818-545-0748
Practice Address - Street 1:210 N CENTRAL AVE STE 105
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-2536
Practice Address - Country:US
Practice Address - Phone:818-545-0746
Practice Address - Fax:818-545-0748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-12
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA751530Medicare Oscar/Certification