MEDICARE: SDX HOME CARE OPERATIONS, LLC

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1851808901
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SDX HOME CARE OPERATIONS, LLC

Provider Business Mailing Address
First Line	:	1 PARK PLZ STE 300
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92614-2510
Country	:	US
Telephone Number	:	800-387-2415
Fax Number	:

Provider Business Practice Location Address
First Line	:	2061 CLARMAR WAY STE B
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95128-1706
Country	:	US
Telephone Number	:	408-446-1199
Fax Number	:

Authorized Official
Title or Position	:	VP, FINANCE
Name	:	RUTH AZANKI
Credential	:
Telephone Number	:	949-621-9649

Provider Enumeration Date	:	01/10/2018
Last Update Date	:	06/19/2023

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