MEDICARE: VIDAS HOSPICE & SENIOR CARE SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1568131092
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIDAS HOSPICE & SENIOR CARE SERVICES INC

Provider Business Mailing Address
First Line	:	146 SUN VILLA CT STE A
Second Line	:
City	:	VISTA
State	:	CA
Zip	:	92084-5851
Country	:	US
Telephone Number	:	760-415-8216
Fax Number	:

Provider Business Practice Location Address
First Line	:	146 SUN VILLA CT STE A
Second Line	:
City	:	VISTA
State	:	CA
Zip	:	92084-5851
Country	:	US
Telephone Number	:	760-415-8216
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	HENRY F SHOWAH
Credential	:	MD
Telephone Number	:	760-415-8216

Provider Enumeration Date	:	09/08/2021
Last Update Date	:	12/03/2025

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