MEDICARE: HUMMINGBIRD HOME HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	201413910234	CA

General Provider Information

NPI Number	:	1003228354
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUMMINGBIRD HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	PO BOX 1658
Second Line	:
City	:	LOS GATOS
State	:	CA
Zip	:	95031-1658
Country	:	US
Telephone Number	:	408-915-6854
Fax Number	:	408-317-0322

Provider Business Practice Location Address
First Line	:	236 N SANTA CRUZ AVE
Second Line	:	SUITE 237A
City	:	LOS GATOS
State	:	CA
Zip	:	95030-7244
Country	:	US
Telephone Number	:	408-915-6854
Fax Number	:	408-317-0322

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MS. ROSANNA L PILLARI
Credential	:	RN
Telephone Number	:	408-915-6854

Provider Enumeration Date	:	05/21/2014
Last Update Date	:	06/17/2014

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