MEDICARE: ASSURE HEALTHCARE SERVICES. INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1043267206
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSURE HEALTHCARE SERVICES. INC.

Provider Business Mailing Address
First Line	:	PO BOX 310183
Second Line	:
City	:	FONTANA
State	:	CA
Zip	:	92331-0183
Country	:	US
Telephone Number	:	909-923-1886
Fax Number	:	909-923-1881

Provider Business Practice Location Address
First Line	:	2000A S. GROVE AVE
Second Line	:	SUITE 105
City	:	ONTARIO
State	:	CA
Zip	:	91761-1428
Country	:	US
Telephone Number	:	909-923-1886
Fax Number	:	909-923-1881

Authorized Official
Title or Position	:	CFO/SECRETARY
Name	:	MRS. OLIVIA M. WHEELER
Credential	:
Telephone Number	:	909-923-1886

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	02/04/2009

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