Provider Demographics
NPI:1487083705
Name:PRIM HOSPICE CARE, INC.
Entity type:Organization
Organization Name:PRIM HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAJIV
Authorized Official - Middle Name:
Authorized Official - Last Name:SANGHVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-883-1604
Mailing Address - Street 1:4413 RIVERSIDE DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-3949
Mailing Address - Country:US
Mailing Address - Phone:714-883-1604
Mailing Address - Fax:501-629-1197
Practice Address - Street 1:4413 RIVERSIDE DR
Practice Address - Street 2:SUITE E
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-3949
Practice Address - Country:US
Practice Address - Phone:714-883-1604
Practice Address - Fax:501-629-1197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based