Healthcare Provider Details

I. General information

NPI: 1609707165
Provider Name (Legal Business Name): FORMUREX HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8026 LORRAINE AVE STE 207
STOCKTON CA
95210-4224
US

IV. Provider business mailing address

8026 LORRAINE AVE STE 207
STOCKTON CA
95210-4224
US

V. Phone/Fax

Practice location:
  • Phone: 209-898-7345
  • Fax: 209-898-7347
Mailing address:
  • Phone: 209-898-7345
  • Fax: 209-898-7347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: NAVJOT KAUR
Title or Position: OWNER/TREASURER
Credential:
Phone: 209-898-7345