Provider Demographics
NPI:1174932735
Name:PROFESSIONAL HOSPICE SERVICES, INC.
Entity type:Organization
Organization Name:PROFESSIONAL HOSPICE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDVARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIELYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-888-7969
Mailing Address - Street 1:2736 E WALNUT ST
Mailing Address - Street 2:STE F
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-3700
Mailing Address - Country:US
Mailing Address - Phone:626-888-7969
Mailing Address - Fax:626-888-7966
Practice Address - Street 1:2736 E WALNUT ST
Practice Address - Street 2:STE F
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3700
Practice Address - Country:US
Practice Address - Phone:626-888-7969
Practice Address - Fax:626-888-7966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-07
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based