MEDICARE: EVERETT HOME HEALTH

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	:	1174118178
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVERETT HOME HEALTH

Provider Business Mailing Address
First Line	:	3318 W BURBANK BLVD STE A
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-2230
Country	:	US
Telephone Number	:	747-336-3232
Fax Number	:

Provider Business Practice Location Address
First Line	:	3318 W BURBANK BLVD STE A
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-2230
Country	:	US
Telephone Number	:	747-336-3232
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MARIAM RUBYAN
Credential	:
Telephone Number	:	747-336-3232

Provider Enumeration Date	:	03/02/2021
Last Update Date	:	03/02/2021

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Directions to “EVERETT HOME HEALTH ” Practice Location

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