MEDICARE: ALL HEART HOME HEALTH CARE OF CAMARILLO LLC

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	:	1235473604
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL HEART HOME HEALTH CARE OF CAMARILLO LLC

Provider Business Mailing Address
First Line	:	400 MOBIL AVE
Second Line	:	SUITE A1
City	:	CAMARILLO
State	:	CA
Zip	:	93010-6338
Country	:	US
Telephone Number	:	805-482-8689
Fax Number	:	805-322-3565

Provider Business Practice Location Address
First Line	:	400 MOBIL AVE
Second Line	:	SUITE A1
City	:	CAMARILLO
State	:	CA
Zip	:	93010-6338
Country	:	US
Telephone Number	:	805-482-8689
Fax Number	:	805-322-3565

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MARK MADURO
Credential	:	RN
Telephone Number	:	805-482-8689

Provider Enumeration Date	:	11/25/2012
Last Update Date	:	11/25/2012

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