MEDICARE: MERIDIAN HOSPICE CARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1376964791
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERIDIAN HOSPICE CARE INC

Provider Business Mailing Address
First Line	:	8400 MAPLE PL STE 109
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91730-3874
Country	:	US
Telephone Number	:	909-484-4810
Fax Number	:	909-484-4271

Provider Business Practice Location Address
First Line	:	8400 MAPLE PL STE 109
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91730-3874
Country	:	US
Telephone Number	:	909-484-4810
Fax Number	:	909-484-4271

Authorized Official
Title or Position	:	CEO
Name	:	MR. GORDHAN PATEL
Credential	:
Telephone Number	:	909-484-4810

Provider Enumeration Date	:	01/03/2014
Last Update Date	:	06/30/2016

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Directions to “MERIDIAN HOSPICE CARE INC ” Practice Location

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