Primal Care Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

PRIMAL CARE HOSPICE, INC.

Practice address

815 S Central Ave Ste 26
Glendale, CA 91204-4301

Phone

(818) 396-4769

NPI assigned

Oct 28, 2020

Organization subpart

No

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

Authorized official

Name

Zaruhi Poghosyan

Title

Ceo

Phone

(818) 396-4769

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN B31683

Legal name

PRIMAL CARE HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jan 7, 2022

Last certification

Jan 7, 2022

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Sep 3, 2020 in CA

Enrollment address

815 S Central Ave
Ste 26
Glendale, CA 91204-4301

Listed as

Primal Care Hospice, IncCCN B31683

Certified

Jan 7, 2022

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 1

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

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1922608959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 S CENTRAL AVE STE 26",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044301",
            "telephone_number": "818-396-4769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 S CENTRAL AVE STE 26",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044301",
            "telephone_number": "818-396-4769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMAL CARE HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-28",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "POGHOSYAN",
        "authorized_official_first_name": "ZARUHI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-396-4769"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.