Healthcare Provider Details

I. General information

NPI: 1295105211
Provider Name (Legal Business Name): OHANA HOSPICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2015
Last Update Date: 10/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 GEORGIA ST SUITE 340
VALLEJO CA
94590-5946
US

IV. Provider business mailing address

301 GEORGIA ST SUITE 340
VALLEJO CA
94590-5946
US

V. Phone/Fax

Practice location:
  • Phone: 408-621-1050
  • Fax:
Mailing address:
  • Phone: 408-621-1050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: FLORO JAY PAGDILAO
Title or Position: PRESIDENT
Credential:
Phone: 408-621-1050