MEDICARE: ANTHEM HEALTHCARE, 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

General Provider Information

NPI Number	:	1841439767
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANTHEM HEALTHCARE, INC.

Provider Business Mailing Address
First Line	:	7753 GRAYSTONE DR
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91304-5250
Country	:	US
Telephone Number	:	818-312-9400
Fax Number	:	818-312-9404

Provider Business Practice Location Address
First Line	:	7753 GRAYSTONE DR
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91304-5250
Country	:	US
Telephone Number	:	818-312-9400
Fax Number	:	818-312-9404

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RUBI PALAFOX ESTEVES
Credential	:	RN
Telephone Number	:	818-312-9400

Provider Enumeration Date	:	02/17/2009
Last Update Date	:	02/17/2009

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