Provider Demographics
NPI:1215506571
Name:GOLDEN STAR HOSPICE CARE LLC
Entity type:Organization
Organization Name:GOLDEN STAR HOSPICE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:OSUAGWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-395-8936
Mailing Address - Street 1:320 E 18TH ST STE C
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-2451
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:320 E 18TH ST STE C
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-2451
Practice Address - Country:US
Practice Address - Phone:925-665-9790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health