MEDICARE: BRIGHTWAY HOSPICE

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	:	1588266134
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHTWAY HOSPICE

Provider Business Mailing Address
First Line	:	415 E HARVARD ST STE 203A
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-1045
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	415 E HARVARD ST STE 203A
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-1045
Country	:	US
Telephone Number	:	818-424-6330
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	HAYK SARKISYAN
Credential	:
Telephone Number	:	818-424-6330

Provider Enumeration Date	:	11/09/2020
Last Update Date	:	03/22/2021

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Directions to “BRIGHTWAY HOSPICE ” Practice Location

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