Provider Demographics
NPI:1093241184
Name:PACIFIC HOME HEALTH INC.
Entity Type:Organization
Organization Name:PACIFIC HOME HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDULKADIR
Authorized Official - Middle Name:M
Authorized Official - Last Name:ADAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-269-3238
Mailing Address - Street 1:2652 HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-1910
Mailing Address - Country:US
Mailing Address - Phone:314-269-3238
Mailing Address - Fax:314-735-8577
Practice Address - Street 1:2652 HICKORY ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-1910
Practice Address - Country:US
Practice Address - Phone:314-269-3238
Practice Address - Fax:314-735-8577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-10
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health