MEDICARE: OLYMPUS HOSPICE 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	:	1497010920
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OLYMPUS HOSPICE INC

Provider Business Mailing Address
First Line	:	6047 TAMPA AVE STE 101
Second Line	:
City	:	TARZANA
State	:	CA
Zip	:	91356-1166
Country	:	US
Telephone Number	:	818-691-1707
Fax Number	:	818-301-0299

Provider Business Practice Location Address
First Line	:	6047 TAMPA AVE STE 101
Second Line	:
City	:	TARZANA
State	:	CA
Zip	:	91356-1166
Country	:	US
Telephone Number	:	818-691-1707
Fax Number	:	818-301-0299

Authorized Official
Title or Position	:	CEO
Name	:	MRS. SVETLANA SARKISYAN
Credential	:
Telephone Number	:	818-691-1707

Provider Enumeration Date	:	07/11/2012
Last Update Date	:	07/11/2012

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