American Heritage Hospice Inc
Organization Active NPI Community Based Hospice Care Agency · Folsom, CA
NPI 1245733328 · NPPES record last updated May 10, 2019
Key facts
- NPI
- 1245733328
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- Legal business name
- AMERICAN HERITAGE HOSPICE INC
- Practice address
- 1837 Iron Point Rd Ste 180
Folsom, CA 95630 - Phone
- (818) 636-0369
- NPI assigned
- Mar 14, 2018
- Organization subpart
- No
Authorized official
- Name
- Vigen Iskandaryan
- Title
- Ceo
- Phone
- (916) 306-5200
Medicare Care Compare: Hospice
- Listed as
- American Heritage Hospice, Inc
- Ownership
- For-Profit
- Certified
- Aug 21, 2019
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Hospice certification: CCN A01642
- Legal name
- AMERICAN HERITAGE HOSPICE INC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Aug 21, 2019
- Last certification
- Aug 21, 2019
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- Corporation · Proprietary
- Incorporated
- Feb 22, 2018 in CA
- Enrollment address
- 1837 Iron Point Rd
Ste 180
Folsom, CA 95630-8781
All disclosed owners & managing parties 1
| Name | Role | Since | Share |
|---|---|---|---|
| Vigen Iskandaryan |
5% Or Greater Direct Ownership Interest |
Sep 25, 2018 | 100% |
| Corporate Officer | Sep 25, 2018 | 100% | |
| Corporate Director |
Sep 25, 2018 | 100% | |
| W-2 Managing Employee |
Sep 25, 2018 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20181017002084 | CA | Part a Provider - Hospice | 7012269129 | Practice locations: Folsom, CA |
National Provider Directory
Locations
1837 Iron Point Rd
Ste 180
Folsom, CA 95630
Phone (818) 636-0369
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Yes |
Addresses
Primary practice location
1837 Iron Point Rd Ste 180
Folsom, CA 95630
Mailing address
1837 Iron Point Rd Ste 180
Folsom, CA 95630-8781
Phone (916) 306-5200
Other providers in Folsom, CA
- Wellington Amaral
- Amazing Care Hospice, LLC.
- Amber Ngoc-Thuy Tran PHD
- Lindsey Ambrose
- American Heritage Hospice #2 Inc
- American River Counseling
- Sadaf Amin
- Roxana Aminbakhsh
- Kathryn Carolin Amirikia
- Anjani K Amladi-Gomez
All providers in Folsom, CA · Community Based Hospice Care Agency in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.