Provider Demographics
NPI:1104557032
Name:BLUE RIBBON HOSPICE INC
Entity type:Organization
Organization Name:BLUE RIBBON HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NORAYR
Authorized Official - Middle Name:
Authorized Official - Last Name:GASPARYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-926-6676
Mailing Address - Street 1:1341 W MOCKINGBIRD LN STE 600W
Mailing Address - Street 2:OFFICE 627
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247
Mailing Address - Country:US
Mailing Address - Phone:214-550-7498
Mailing Address - Fax:
Practice Address - Street 1:1341 W MOCKINGBIRD LN STE 600W
Practice Address - Street 2:OFFICE 627
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247
Practice Address - Country:US
Practice Address - Phone:214-550-7498
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based