MEDICARE: CALIFORNIA HOMECARE PHARMACY, 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	980000992	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992709950
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALIFORNIA HOMECARE PHARMACY, INC.

Provider Business Mailing Address
First Line	:	150 LONG BEACH BLVD
Second Line	:	SUITE #303
City	:	LONG BEACH
State	:	CA
Zip	:	90802-4817
Country	:	US
Telephone Number	:	562-799-1234
Fax Number	:	562-799-1934

Provider Business Practice Location Address
First Line	:	150 LONG BEACH BLVD
Second Line	:	SUITE #303
City	:	LONG BEACH
State	:	CA
Zip	:	90802-4817
Country	:	US
Telephone Number	:	562-799-1234
Fax Number	:	562-799-1934

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	PARISA KOMPANI JR.
Credential	:
Telephone Number	:	815-442-0008

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	10/05/2023

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