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General NPI Number Information
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NPI Number | 1598339822
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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 | 05/20/2021
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Last Update Date | 05/20/2021
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Provider Practice Location Address
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Address Line | 187 TANK FARM RD STE 110
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-7084
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Country | US
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Telephone | 805-540-2780
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Fax |
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Provider Business Mailing Address
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Address Line | 243 GRANADA DR STE 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 |
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Authorized Official
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Title or Position | PRESIDENT
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Name | 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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