Healthcare Provider Details

I. General information

NPI: 1508937277
Provider Name (Legal Business Name): CHILDRENS HOSPITAL HOMECARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7555 N DEL MAR AVE SUITE 101
FRESNO CA
93711-6860
US

IV. Provider business mailing address

7555 N DEL MAR AVE SUITE 101
FRESNO CA
93711-6860
US

V. Phone/Fax

Practice location:
  • Phone: 559-353-7125
  • Fax: 559-353-7462
Mailing address:
  • Phone: 559-353-7125
  • Fax: 559-353-7462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License NumberPHY44810
License Number StateCA

VIII. Authorized Official

Name: MR. JOHN THOMAS MORRISON
Title or Position: ADMINISTRATOR
Credential:
Phone: 559-353-7125