Fortis Hospice & Palliative Care, Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

FORTIS HOSPICE & PALLIATIVE CARE, INC

Practice address

5236 Colodny Dr Ste 208a
Agoura Hills, CA 91301-2624

Phone

(747) 212-0350

NPI assigned

Oct 21, 2020

Last updated

Oct 21, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sweety Eapen

Title

Owner

Phone

(818) 825-4103

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603238400000",
    "number": "1396344396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5236 COLODNY DR STE 208A",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913012624",
            "telephone_number": "747-212-0350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5236 COLODNY DR STE 208A",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913012624",
            "telephone_number": "747-212-0350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORTIS HOSPICE & PALLIATIVE CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-21",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A",
        "authorized_official_last_name": "EAPEN",
        "authorized_official_first_name": "SWEETY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-825-4103"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "WWW.GMAIL.COM",
            "affiliation": "N",
            "address_1": "5236 Colodny Dr Ste 208A",
            "city": "Agoura Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913012624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.