Provider Demographics
NPI:1053911412
Name:BLUE IVORY AND PALLIATIVE CARE, INC
Entity type:Organization
Organization Name:BLUE IVORY AND PALLIATIVE CARE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ADWOA SERWA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSEI NAYRKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-242-1831
Mailing Address - Street 1:2777 PACIFIC AVE STE J
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-2625
Mailing Address - Country:US
Mailing Address - Phone:562-242-1831
Mailing Address - Fax:562-242-1831
Practice Address - Street 1:2777 PACIFIC AVE STE J
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2625
Practice Address - Country:US
Practice Address - Phone:562-242-1831
Practice Address - Fax:562-258-7216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-27
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251F00000XAgenciesHome Infusion
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies