MEDICARE: PROMPTCARE HEALTH 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		CA

General Provider Information

NPI Number	:	1285637603
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROMPTCARE HEALTH SERVICES INC.

Provider Business Mailing Address
First Line	:	454 S CENTRAL AVE
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91204-4760
Country	:	US
Telephone Number	:	818-500-1902
Fax Number	:

Provider Business Practice Location Address
First Line	:	454 S CENTRAL AVE
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91204-4760
Country	:	US
Telephone Number	:	818-500-1902
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	PERFECTO F GALLARDO
Credential	:
Telephone Number	:	818-500-1902

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	08/22/2020

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