Healthcare Provider Details

I. General information

NPI: 1104861715
Provider Name (Legal Business Name): AMERICAN HOME HEALTH CARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6710 BROCKTON AVE
RIVERSIDE CA
92506-3022
US

IV. Provider business mailing address

6710 BROCKTON AVE
RIVERSIDE CA
92506-3022
US

V. Phone/Fax

Practice location:
  • Phone: 951-686-3980
  • Fax: 951-686-7911
Mailing address:
  • Phone: 951-686-3980
  • Fax: 951-686-7911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number100418
License Number StateCA

VIII. Authorized Official

Name: MS. GINGER MEGYES
Title or Position: GENERAL MANAGER
Credential:
Phone: 951-686-3980