Provider Demographics
NPI:1053850529
Name:AMETRINE HOSPICE
Entity type:Organization
Organization Name:AMETRINE HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOD
Authorized Official - Prefix:
Authorized Official - First Name:ZOGRAB
Authorized Official - Middle Name:
Authorized Official - Last Name:VARDERESYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-290-3801
Mailing Address - Street 1:133 N ALTADENA DR STE 304
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-7339
Mailing Address - Country:US
Mailing Address - Phone:626-888-4061
Mailing Address - Fax:626-628-3615
Practice Address - Street 1:3100 W BURBANK BLVD STE 204
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-2348
Practice Address - Country:US
Practice Address - Phone:818-290-3801
Practice Address - Fax:818-290-3805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-16
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based