MEDICARE: FOYER HOME HEALTH SERVICE

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	:	1942053202
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOYER HOME HEALTH SERVICE

Provider Business Mailing Address
First Line	:	17439 FAIRLIE RD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92128-3953
Country	:	US
Telephone Number	:	858-205-7580
Fax Number	:

Provider Business Practice Location Address
First Line	:	17439 FAIRLIE RD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92128-3953
Country	:	US
Telephone Number	:	858-205-7580
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	IRVING ALGERELL WALL
Credential	:	M.B.A.
Telephone Number	:	858-205-7580

Provider Enumeration Date	:	04/08/2024
Last Update Date	:	04/08/2024

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Directions to “FOYER HOME HEALTH SERVICE ” Practice Location

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