MEDICARE: EMERITUS HOME HEALTH 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	:	1447550165
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMERITUS HOME HEALTH INC

Provider Business Mailing Address
First Line	:	1590 OAKLAND RD
Second Line	:	STE. B114
City	:	SAN JOSE
State	:	CA
Zip	:	95131-2443
Country	:	US
Telephone Number	:	408-437-3045
Fax Number	:	408-693-3742

Provider Business Practice Location Address
First Line	:	1590 OAKLAND RD
Second Line	:	STE. B114
City	:	SAN JOSE
State	:	CA
Zip	:	95131-2443
Country	:	US
Telephone Number	:	408-437-3045
Fax Number	:	408-693-3742

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MR. MIGUEL PANGILINAN
Credential	:
Telephone Number	:	408-437-3045

Provider Enumeration Date	:	10/28/2010
Last Update Date	:	10/28/2010

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