Public record

CMS Hospice All Owners

Associate id: 5698042406 · 9 matching records

Enrollment id
O20170526002076
Associate id
5698042406
Organization name
AXEL HOSPICE CARE,LLC
Associate id - owner
2365571353
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2020-03-11
First name - owner
ELSY J
Last name - owner
BENJAMIN
Title - owner
ALT.SUPERVISING NURSE
Enrollment id
O20170526002076
Associate id
5698042406
Organization name
AXEL HOSPICE CARE,LLC
Associate id - owner
2961660030
Type - owner
I
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2019-10-01
First name - owner
MATHEW
Last name - owner
KORAH
Percentage ownership
60
Enrollment id
O20170526002076
Associate id
5698042406
Organization name
AXEL HOSPICE CARE,LLC
Associate id - owner
2961660030
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2019-12-05
First name - owner
MATHEW
Last name - owner
KORAH
Enrollment id
O20170526002076
Associate id
5698042406
Organization name
AXEL HOSPICE CARE,LLC
Associate id - owner
2961660030
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2019-12-05
First name - owner
MATHEW
Last name - owner
KORAH
Enrollment id
O20170526002076
Associate id
5698042406
Organization name
AXEL HOSPICE CARE,LLC
Associate id - owner
5294821591
Type - owner
I
Role code - owner
25
Role text - owner
CONTRACTED MANAGING EMPLOYEE
Association date - owner
2022-01-01
First name - owner
MARIA PHARAH
Last name - owner
AMBALONG
Title - owner
MD;
Enrollment id
O20170526002076
Associate id
5698042406
Organization name
AXEL HOSPICE CARE,LLC
Associate id - owner
6901030253
Type - owner
I
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2019-12-05
First name - owner
SUMA
Middle name - owner
C
Last name - owner
JACOB
Percentage ownership
40
Enrollment id
O20170526002076
Associate id
5698042406
Organization name
AXEL HOSPICE CARE,LLC
Associate id - owner
6901030253
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2019-12-05
First name - owner
SUMA
Middle name - owner
C
Last name - owner
JACOB
Title - owner
OWNER/PRESIDENT
Enrollment id
O20170526002076
Associate id
5698042406
Organization name
AXEL HOSPICE CARE,LLC
Associate id - owner
6901030253
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2019-12-05
First name - owner
SUMA
Middle name - owner
C
Last name - owner
JACOB
Title - owner
ADMINISTRATOR
Enrollment id
O20170526002076
Associate id
5698042406
Organization name
AXEL HOSPICE CARE,LLC
Associate id - owner
7517311715
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2022-05-25
First name - owner
SHAIROSE
Last name - owner
GILANI
Title - owner
SUPERVISING NURSE

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