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General NPI Number Information
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NPI Number | 1710223631
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Entity Type | Organization
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Legal Business Name | MERCURY HOME HEALTH SERVICES INC
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Dates
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Enumeration Date | 12/20/2012
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Last Update Date | 03/25/2019
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Provider Practice Location Address
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Address Line | 2829 N GLENOAKS BLVD STE 104
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City | BURBANK
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State | CA
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Zip | 91504-2660
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Country | US
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Telephone | 747-241-8593
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Fax | 747-241-8596
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Provider Business Mailing Address
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Address Line | 1241 S GLENDALE AVE, STE 305-D
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City | GLENDALE
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State | CA
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Zip | 91205-3204
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Country | US
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Telephone | 818-925-6475
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Fax | 818-459-6975
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Authorized Official
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Title or Position | CEO
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Name | MR. SAMUEL ALAVERDYAN
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Credential |
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Telephone | 747-241-8593
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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 | 550002600
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License Number State | CA
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