NPI Code Details Logo

NPI 1639725021

NPI 1639725021 : MADISON HOSPICE, INC. : WEST COVINA, CA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1639725021
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    MADISON HOSPICE, INC. 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    08/13/2019
-----------------------------------------------------
    Last Update Date     |    04/09/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1619 W GARVEY AVE N STE 107 
-----------------------------------------------------
    City                 |    WEST COVINA
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    91790-2146
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    626-727-6071
-----------------------------------------------------
    Fax                  |    626-727-6075
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1619 W GARVEY AVE N STE 107 
-----------------------------------------------------
    City                 |    WEST COVINA
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    91790-2146
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    626-727-6071
-----------------------------------------------------
    Fax                  |    626-727-6075
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    CEO
-----------------------------------------------------
    Name                 |    MRS. CHARLOTRTE  JOSE 
-----------------------------------------------------
    Credential           |    RN
-----------------------------------------------------
    Telephone            |    909-764-1054
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    251E00000X
-----------------------------------------------------
    Taxonomy Name        |    Home Health Agency
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.