MEDICARE: PRIDE 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	:	1447691282
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIDE HOSPICE CARE INC.

Provider Business Mailing Address
First Line	:	2501 W BURBANK BLVD STE 206
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-2347
Country	:	US
Telephone Number	:	818-333-5876
Fax Number	:	818-333-5875

Provider Business Practice Location Address
First Line	:	2501 W BURBANK BLVD STE 206
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-2347
Country	:	US
Telephone Number	:	818-333-5876
Fax Number	:	818-333-5875

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. NATHAN JULIAN
Credential	:
Telephone Number	:	818-333-5876

Provider Enumeration Date	:	07/09/2013
Last Update Date	:	06/20/2016

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Directions to “PRIDE HOSPICE CARE INC. ” Practice Location

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