Provider Demographics
NPI:1053066530
Name:DMC HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:DMC HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AXLE ROSS
Authorized Official - Middle Name:
Authorized Official - Last Name:DE VILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-810-4026
Mailing Address - Street 1:25101 THE OLD RD STE 124
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91381-2206
Mailing Address - Country:US
Mailing Address - Phone:562-810-4026
Mailing Address - Fax:
Practice Address - Street 1:25101 THE OLD RD STE 124
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91381-2206
Practice Address - Country:US
Practice Address - Phone:562-810-4026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC4832621OtherARTICLES OF INCORPORATION