Medline Quality Hospice Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

MEDLINE QUALITY HOSPICE INC

Practice address

418 N Glendale Ave Ste C
Glendale, CA 91206-3314

Phone

(818) 659-8290

NPI assigned

Jul 16, 2020

Organization subpart

No

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

Authorized official

Name

Narine Dallakyan

Title

Ceo

Phone

(818) 659-8290

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN B21636

Legal name

MEDLINE QUALITY HOSPICE INC

Doing business as

REVIK HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jul 12, 2021

Last certification

Jul 12, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

May 15, 2020 in CA

Enrollment address

418 N Glendale Ave
Ste C
Glendale, CA 91206-3314

Listed as

Medline Quality Hospice, IncCCN B21636

Ownership

For-Profit

Certified

Jul 12, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Mark N Gobrial, M.D.

  • Internal Medicine Physician
  • Mission Hills, CA
  • NPI 1437577343

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594857600000",
    "number": "1740898741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 N GLENDALE AVE STE C",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912063314",
            "telephone_number": "818-659-8290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 N GLENDALE AVE STE C",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912063314",
            "telephone_number": "818-659-8290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDLINE QUALITY HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-16",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A",
        "authorized_official_last_name": "DALLAKYAN",
        "authorized_official_first_name": "NARINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-659-8290"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medstar Physical Therapy. Inc.
• Medvec
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• Community Based Hospice Care Agency in Glendale, CA
• Providers in Glendale, CA by specialty
• Community Based Hospice Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.