MEDICARE: PILGRIM 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	:	1508459397
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PILGRIM HOSPICE, INC

Provider Business Mailing Address
First Line	:	125 S LOUISE ST STE 120
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-1024
Country	:	US
Telephone Number	:	818-877-5584
Fax Number	:	818-484-2015

Provider Business Practice Location Address
First Line	:	125 S LOUISE ST STE 120
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-1024
Country	:	US
Telephone Number	:	818-877-5584
Fax Number	:	818-484-2015

Authorized Official
Title or Position	:	CEO
Name	:	MARIAM MUSHEGHYAN
Credential	:
Telephone Number	:	818-877-5584

Provider Enumeration Date	:	02/12/2021
Last Update Date	:	02/26/2021

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