MEDICARE: SALCARE HOME HEALTH SERVICES, INC

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	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356321756
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SALCARE HOME HEALTH SERVICES, INC

Provider Business Mailing Address
First Line	:	1159 W EL SEGUNDO BLVD
Second Line	:
City	:	GARDENA
State	:	CA
Zip	:	90247-1603
Country	:	US
Telephone Number	:	323-777-9339
Fax Number	:	323-777-9361

Provider Business Practice Location Address
First Line	:	1156 W 127TH ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90044-1020
Country	:	US
Telephone Number	:	323-777-9339
Fax Number	:	323-777-9361

Authorized Official
Title or Position	:	CEO/ADMINISTRATOR
Name	:	SALLY OKEKE
Credential	:	RN, MN
Telephone Number	:	323-777-9339

Provider Enumeration Date	:	01/20/2006
Last Update Date	:	11/16/2007

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