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General NPI Number Information
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NPI Number | 1053911412
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Entity Type | Organization
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Legal Business Name | BLUE IVORY AND PALLIATIVE CARE, INC
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Dates
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Enumeration Date | 10/27/2020
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Last Update Date | 05/19/2021
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Provider Practice Location Address
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Address Line | 2777 PACIFIC AVE STE J
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City | LONG BEACH
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State | CA
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Zip | 90806-2625
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Country | US
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Telephone | 562-242-1831
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Fax | 562-258-7216
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Provider Business Mailing Address
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Address Line | 2777 PACIFIC AVE STE J
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City | LONG BEACH
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State | CA
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Zip | 90806-2625
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Country | US
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Telephone | 562-242-1831
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Fax | 562-242-1831
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ADWOA SERWA OSEI NAYRKO
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Credential |
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Telephone | 562-242-1831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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Taxonomy #3
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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