Provider Demographics
NPI:1003401712
Name:MEDICUS COMMUNITY HOME HEALTH
Entity Type:Organization
Organization Name:MEDICUS COMMUNITY HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARIK
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEKSANDRYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-522-1716
Mailing Address - Street 1:16555A GAULT ST
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-3706
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16555A GAULT ST
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3706
Practice Address - Country:US
Practice Address - Phone:818-522-1716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health