Healthcare Provider Details

I. General information

NPI: 1518569219
Provider Name (Legal Business Name): ST. JOSEPH HEALTH SYSTEM HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2020
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2703 N ONTARIO ST STE 120&130
BURBANK CA
91504-2508
US

IV. Provider business mailing address

2703 N ONTARIO ST STE 120&130
BURBANK CA
91504-2508
US

V. Phone/Fax

Practice location:
  • Phone: 818-847-6558
  • Fax:
Mailing address:
  • Phone: 818-847-6558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: DONALD WAYNE ANDERSON JR.
Title or Position: ASSISTANT SECRETARY FOR ENROLLMENT
Credential:
Phone: 425-358-9786