MEDICARE: MEDICO 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	:	1851559660
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICO HOME HEALTH, INC.

Provider Business Mailing Address
First Line	:	11501 DUBLIN BLVD
Second Line	:	SUITE #201
City	:	DUBLIN
State	:	CA
Zip	:	94568-2826
Country	:	US
Telephone Number	:	209-835-1256
Fax Number	:	209-839-0731

Provider Business Practice Location Address
First Line	:	11501 DUBLIN BLVD
Second Line	:	SUITE #201
City	:	DUBLIN
State	:	CA
Zip	:	94568-2826
Country	:	US
Telephone Number	:	209-835-1256
Fax Number	:	209-839-0731

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MS. AUDREY M MIDDLETON JR.
Credential	:
Telephone Number	:	510-926-7289

Provider Enumeration Date	:	05/28/2008
Last Update Date	:	09/28/2009

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