Provider Demographics
NPI:1710224712
Name:COMPANION HOSPICE AND PALLIATIVE CARE SERVICES, LLC
Entity type:Organization
Organization Name:COMPANION HOSPICE AND PALLIATIVE CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:MS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-664-0974
Mailing Address - Street 1:6133 BRISTOL PKWY
Mailing Address - Street 2:#180
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6609
Mailing Address - Country:US
Mailing Address - Phone:855-810-1970
Mailing Address - Fax:714-557-4439
Practice Address - Street 1:6133 BRISTOL PKWY
Practice Address - Street 2:#180
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6609
Practice Address - Country:US
Practice Address - Phone:855-810-1970
Practice Address - Fax:714-557-4439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-10
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA751631Medicare Oscar/Certification