=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093155343
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PREMIER HOSPICE & HOMECARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/01/2013
-----------------------------------------------------
Last Update Date | 10/12/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 23300 CINEMA DR STE 285
-----------------------------------------------------
City | VALENCIA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91355-1789
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-857-1467
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 23300 CINEMA DR STE 285
-----------------------------------------------------
City | VALENCIA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91355-1789
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-857-1467
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VP
-----------------------------------------------------
Name | FRANKLIN S BARZAGA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 661-977-3504
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------