Provider Demographics
NPI:1053066829
Name:GOLDEN HOSPICE CARE INC
Entity type:Organization
Organization Name:GOLDEN HOSPICE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOVHANNISYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-877-2925
Mailing Address - Street 1:4150 W PEORIA AVE STE B113J
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-3900
Mailing Address - Country:US
Mailing Address - Phone:747-307-5566
Mailing Address - Fax:747-264-9469
Practice Address - Street 1:4150 W PEORIA AVE STE B113J
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-3900
Practice Address - Country:US
Practice Address - Phone:747-877-2925
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-19
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZHSPC13276OtherAZDHS LICENSE