MEDICARE: CORE HOSPICE CARE

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	:	1386224459
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORE HOSPICE CARE

Provider Business Mailing Address
First Line	:	125 S LOUISE ST STE 114
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-1024
Country	:	US
Telephone Number	:	818-318-6342
Fax Number	:

Provider Business Practice Location Address
First Line	:	125 S LOUISE ST STE 114
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-1024
Country	:	US
Telephone Number	:	818-318-6342
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MARINE VARDANYAN
Credential	:
Telephone Number	:	818-318-6342

Provider Enumeration Date	:	04/12/2021
Last Update Date	:	04/16/2021

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Directions to “CORE HOSPICE CARE ” Practice Location

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