Healthcare Provider Details

I. General information

NPI: 1770518292
Provider Name (Legal Business Name): ATWELL HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 04/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3299 E HILL ST STE 301
SIGNAL HILL CA
90755-1231
US

IV. Provider business mailing address

3299 E HILL ST STE 301
SIGNAL HILL CA
90755-1231
US

V. Phone/Fax

Practice location:
  • Phone: 562-597-6800
  • Fax: 562-597-6844
Mailing address:
  • Phone: 562-597-6800
  • Fax: 562-597-6844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY47533
License Number StateCA

VIII. Authorized Official

Name: ROBERT KELLEY
Title or Position: PRESIDENT
Credential:
Phone: 562-597-6800