Provider Demographics
NPI:1396125969
Name:PRIME CHOICE HEALTH CARE HOSPICE INC
Entity type:Organization
Organization Name:PRIME CHOICE HEALTH CARE HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TONNY
Authorized Official - Middle Name:
Authorized Official - Last Name:MWANGANGI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-801-2138
Mailing Address - Street 1:1421 E COOLEY DR STE 8
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-3979
Mailing Address - Country:US
Mailing Address - Phone:909-653-4545
Mailing Address - Fax:909-653-4599
Practice Address - Street 1:1421 E COOLEY DR STE 8
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324
Practice Address - Country:US
Practice Address - Phone:909-653-4545
Practice Address - Fax:909-653-4599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-08
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based