MEDICARE: FIT HOME HEALTH 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1811703580
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIT HOME HEALTH INC

Provider Business Mailing Address
First Line	:	2060 HUNTINGTON DR STE 9A
Second Line	:
City	:	SAN MARINO
State	:	CA
Zip	:	91108-2044
Country	:	US
Telephone Number	:	626-887-0050
Fax Number	:	626-887-0060

Provider Business Practice Location Address
First Line	:	2060 HUNTINGTON DR STE 9A
Second Line	:
City	:	SAN MARINO
State	:	CA
Zip	:	91108-2044
Country	:	US
Telephone Number	:	626-887-0050
Fax Number	:	626-887-0060

Authorized Official
Title or Position	:	CEO
Name	:	ANNA DASHYAN
Credential	:
Telephone Number	:	626-887-0050

Provider Enumeration Date	:	12/09/2024
Last Update Date	:	12/09/2024

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