Healthcare Provider Details

I. General information

NPI: 1134455280
Provider Name (Legal Business Name): PACIFIC HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2009
Last Update Date: 10/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SOUTH MIDDLE ROAD CHALAN KIYA
SAIPAN MP
96950
US

IV. Provider business mailing address

PMB 376 BOX 10001
SAIPAN MP
96950
US

V. Phone/Fax

Practice location:
  • Phone: 670-234-2273
  • Fax: 670-284-2274
Mailing address:
  • Phone: 670-234-2273
  • Fax: 670-234-2274

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: MR. MICHAEL CURTIS BROWN
Title or Position: MANAGING MEMBER
Credential:
Phone: 670-323-6003