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NPI Code Detail

MEDICARE: HOSPICE OF ST. GEORGE, INC.

MEDICARE: HOSPICE OF ST. GEORGE, 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
1251G00000XCommunity Based Hospice Care Agency

General Provider Information

NPI Number : 1508165069
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOSPICE OF ST. GEORGE, INC.
Provider Business Mailing Address
First Line : 415 E HARVARD ST
Second Line : STE 101
City : GLENDALE
State : CA
Zip : 91205-1057
Country : US
Telephone Number : 818-553-8000
Fax Number : 818-553-8118
Provider Business Practice Location Address
First Line : 415 E HARVARD ST
Second Line : STE 101
City : GLENDALE
State : CA
Zip : 91205-1057
Country : US
Telephone Number : 818-553-8000
Fax Number : 818-553-8118
Authorized Official
Title or Position : CEO
Name : ANGELA KHANJYAN
Credential :
Telephone Number : 818-553-8000
Provider Enumeration Date : 03/23/2011
Last Update Date : 03/23/2011

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Directions to “HOSPICE OF ST. GEORGE, INC. ” Practice Location

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