MEDICARE: MERCURY HOME 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	550002600	CA

General Provider Information

NPI Number	:	1710223631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCURY HOME HEALTH SERVICES INC

Provider Business Mailing Address
First Line	:	1241 S GLENDALE AVE,
Second Line	:	STE 305-D
City	:	GLENDALE
State	:	CA
Zip	:	91205-3204
Country	:	US
Telephone Number	:	818-925-6475
Fax Number	:	818-459-6975

Provider Business Practice Location Address
First Line	:	2829 N GLENOAKS BLVD STE 104
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91504-2660
Country	:	US
Telephone Number	:	747-241-8593
Fax Number	:	747-241-8596

Authorized Official
Title or Position	:	CEO
Name	:	MR. SAMUEL ALAVERDYAN
Credential	:
Telephone Number	:	747-241-8593

Provider Enumeration Date	:	12/20/2012
Last Update Date	:	03/25/2019

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