Provider Demographics
NPI:1194378521
Name:AMTRUST HOME HEALTH LLC
Entity Type:Organization
Organization Name:AMTRUST HOME HEALTH LLC
Other - Org Name:AMTRUST HOME HEALTH LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EVELIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:214-662-0982
Mailing Address - Street 1:5301 ALPHA RD APT 332
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-4374
Mailing Address - Country:US
Mailing Address - Phone:214-662-0982
Mailing Address - Fax:214-594-8862
Practice Address - Street 1:5301 ALPHA RD APT 332
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-4374
Practice Address - Country:US
Practice Address - Phone:214-662-0982
Practice Address - Fax:214-594-8862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-24
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion