MEDICARE: MEADOWS 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	:	1710307699
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEADOWS HOSPICE CARE, INC.

Provider Business Mailing Address
First Line	:	3800 BARHAM BLVD STE 322
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90068-1095
Country	:	US
Telephone Number	:	213-265-7179
Fax Number	:	213-265-7581

Provider Business Practice Location Address
First Line	:	3800 BARHAM BLVD STE 322
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90068-1095
Country	:	US
Telephone Number	:	213-265-7179
Fax Number	:	213-265-7581

Authorized Official
Title or Position	:	COO
Name	:	BRENT EMERY
Credential	:
Telephone Number	:	213-265-7179

Provider Enumeration Date	:	04/18/2014
Last Update Date	:	04/24/2023

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