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General NPI Number Information
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NPI Number | 1265996771
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Entity Type | Organization
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Legal Business Name | PRIMEMED HOME HEALTH CARE, INC.
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Dates
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Enumeration Date | 01/29/2019
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 12440 FIRESTONE BLVD STE 2011
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City | NORWALK
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State | CA
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Zip | 90650-4328
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Country | US
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Telephone | 562-204-6890
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Fax |
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Provider Business Mailing Address
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Address Line | 12440 FIRESTONE BLVD STE 2011
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City | NORWALK
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State | CA
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Zip | 90650-4328
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Country | US
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Telephone | 562-204-6890
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. RAJ AUGUSTINE
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Credential |
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Telephone | 951-480-5030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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