MEDICARE: BLOOMING ROSE 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1831715077
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLOOMING ROSE HOSPICE, INC.

Provider Business Mailing Address
First Line	:	3089 N LIMA ST # C
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91504-2013
Country	:	US
Telephone Number	:	818-208-3066
Fax Number	:	818-226-3246

Provider Business Practice Location Address
First Line	:	3089 N LIMA ST # C
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91504-2013
Country	:	US
Telephone Number	:	818-208-3066
Fax Number	:	818-226-3246

Authorized Official
Title or Position	:	CEO
Name	:	MR. ARTEN BAGUMYAN
Credential	:
Telephone Number	:	818-208-3066

Provider Enumeration Date	:	06/23/2020
Last Update Date	:	04/26/2022

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