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General NPI Number Information
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NPI Number | 1376998401
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Entity Type | Organization
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Legal Business Name | CENTRAL COAST HOME HEALTH, INC.
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Dates
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Enumeration Date | 04/26/2016
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Last Update Date | 11/02/2020
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Provider Practice Location Address
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Address Line | 243 GRANADA DR STE A SUITE A
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-7336
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Country | US
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Telephone | 805-540-2780
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Fax | 805-540-2158
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Provider Business Mailing Address
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Address Line | 253 GRANADA DR SUITE D
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-7340
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Country | US
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Telephone | 805-540-2780
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Fax | 805-540-2158
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BRIAN PRITT
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Credential |
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Telephone | 805-543-2244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 54252
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License Number State | CA
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