Provider Demographics
NPI:1164018875
Name:PEARL HEALTHCARE INC
Entity Type:Organization
Organization Name:PEARL HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGORI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-213-0657
Mailing Address - Street 1:4601 FAIRFAX DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-1527
Mailing Address - Country:US
Mailing Address - Phone:571-370-9060
Mailing Address - Fax:757-231-3126
Practice Address - Street 1:4601 FAIRFAX DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1527
Practice Address - Country:US
Practice Address - Phone:571-370-9060
Practice Address - Fax:757-231-3126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health