=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821270851
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | US MEDTRADE HOME HEALTHCARE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/30/2007
-----------------------------------------------------
Last Update Date | 04/11/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 221 E GLENOAKS BLVD SUITE 100
-----------------------------------------------------
City | GLENDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91207-2119
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-550-0877
-----------------------------------------------------
Fax | 818-550-0878
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 221 E GLENOAKS BLVD SUITE 100
-----------------------------------------------------
City | GLENDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91207-2085
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-550-0877
-----------------------------------------------------
Fax | 818-550-0878
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | ANNA SINANIAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 818-550-0877
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 550000905
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------