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NPI Code Detail

MEDICARE: BEAR VALLEY HOSPICE LLC

MEDICARE: BEAR VALLEY HOSPICE LLC
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 : 1750712410
Entity Type Code : Organization
Provider Name (Legal Business Name) : BEAR VALLEY HOSPICE LLC
Provider Business Mailing Address
First Line : PO BOX 140
Second Line :
City : BIG BEAR CITY
State : CA
Zip : 92314-0140
Country : US
Telephone Number : 909-281-2550
Fax Number : 909-281-2551
Provider Business Practice Location Address
First Line : 909 W BIG BEAR BLVD
Second Line :
City : BIG BEAR CITY
State : CA
Zip : 92314-9661
Country : US
Telephone Number : 909-281-2550
Fax Number : 909-281-2551
Authorized Official
Title or Position : CO-OWNER
Name : SPENCER STEWART
Credential :
Telephone Number : 909-281-2550
Provider Enumeration Date : 12/06/2013
Last Update Date : 01/30/2018

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Directions to “BEAR VALLEY HOSPICE LLC ” Practice Location

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