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General NPI Number Information
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NPI Number | 1073925533
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Entity Type | Organization
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Legal Business Name | GALAXY HOSPICE, INC
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Dates
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Enumeration Date | 06/02/2014
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Last Update Date | 11/05/2014
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Provider Practice Location Address
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Address Line | 4055 SPENCER ST STE 217
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City | LAS VEGAS
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State | NV
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Zip | 89119-9303
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Country | US
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Telephone | 702-988-6789
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Fax | 702-988-8813
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Provider Business Mailing Address
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Address Line | 4055 SPENCER ST STE 217
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City | LAS VEGAS
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State | NV
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Zip | 89119-9303
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Country | US
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Telephone | 702-988-6789
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Fax | 702-988-8813
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALPHIE DE GUZMAN
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Credential |
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Telephone | 510-364-5158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 7765HPC-0
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License Number State | NV
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